Appeals Specialist
at Medix

Date Posted: 10/20/2019

Job Description

Position: Authorization and Appeals Specialist

Schedule: M-F 8:30-4:30pm

Hours Per Week:
40
  1. Review medical records and prepare authorizations as appropriate.

  2. Review denials and medical records and prepare appeals as appropriate.

  3. Follow up on all pending authorizations and appeals until resolution.

  4. Check third-party payer eligibility to ensure that the information provided matches the database information.

  5. Communicate authorization and appeal status to assigned facilities and onsite HCFS staff.

  6. Submits and/or mails the retro-authorization form and supporting documentation to payer program.

  7. Updates accounts based on balance and updates systems as work is completed.

  8. Prepares, daily weekly and monthly reports for facilities and other departments as appropriate.

  9. Communicates issues and project status to management as needed.

  10. Follows suspense dates in internal system to update account status on the authorizations or appeals on a timely basis.

  11. Demonstrates the ability to handle and manage multiple duties and remain focused on the completion of these essential duties for long periods of time.

  12. Interacts with key hospital contacts to provide updates our account progress and inform of our production and success rates. Works collegially and professionally with all internal and external staff.

  13. Consistent punctuality and attendance is required.

  14. Other duties and projects as assigned by management.

Reference number: 90368

Job Requirements

Knowledge of disease process EPIC Experience Appeals Experience Retro Authorization Read medical records

Job Snapshot

  • Employee Type: Full-Time
  • Location: Frisco, TX
  • Job Type: Health Care
  • Experience: Not Specified
  • Date Posted: 10/20/2019

About Us

Medix provides workforce solutions to clients and creates opportunity for talent representing a variety of industries through our Healthcare, Scientific and Information Technology divisions. We have earned our reputation as an industry leader by providing unsurpassed customer service and top quality professionals to our clients.

At Medix we are extremely dedicated to our candidates, providing them with the best advice, support and direction during their job search. We work with all of our candidates personally to understand their skills and aspirations and best match them with opportunities that fit their goals. As we place contract, contract-to-hire and direct hire employment plans, we offer the flexibility to accommodate your schedule and needs.  We will also provide guidance and support during the interview process.  The benefits at Medix don’t stop there. After being employed for 30 days and averaging 30 hours per week for those 30 days, you become eligible for our benefit program.

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