Appeal Resolution Specialist jobs in Louisiana

Job Category: Finance

Job Type: Full-Time

Job Location: LA-Lafayette

Facility Type: Corporate

Shift Type (Clinical Positions): Day Shift

Summary

At AMG we offer our employees much more than just a job in the healthcare industry. We offer unique career opportunities for people who are called to make a healing difference in the lives of others and desire to be part of a team that contributes to making a difference each day for our patients. We invite you to join our team and share your gifts and talents. In addition to market competitive pay rates and benefits in the Lafayette market, you will have the opportunity to work for an Employee Stock Ownership Plan (ESOP), as AMG is an employee-owned company!

AMG, Integrated Healthcare Management (AMG Corporate) is seeking a Claims Resolution Specialist in Lafayette, Louisiana. The Claims Resolution Specialist provides support for the Billing Specialists and the corporate office team in relation to managing incorrect contracted payments with managed care payors to seek resolution and file necessary appeals. The Claims Resolution Specialist will be able to research payor issues, interpret contracts, write appeals, and communicate effectively and diplomatically with payor contacts. The candidate must possess strong communication skills, excellent customer services skills, and be able to work collaboratively with a team. This position is located in Lafayette, Louisiana and works out of the Corporate office.

Join our dynamic team and enjoy a career where you can make a difference with AMG Integrated Healthcare Management!

Full-Time employees are offered a comprehensive package including competitive pay, direct deposit, dual medical insurance options, dental insurance, long-term disability insurance, life insurance, AD&D insurance, vision insurance, multiple voluntary insurance options, paid holidays, paid vacation time, paid sick time, optional credit union membership, personal cellular discount options, 401(k) retirement plan with generous company contribution, and participation in our ESOP additional retirement benefit as a part of an employee-owned company.

Job Requirements

• Position located in Lafayette, Louisiana.
• Strong knowledge of MS Word and Excel.
• Clinical/Managed Care experience required.
• Requires a strong Managed Care Appeals background with experience in the Post-Acute setting.
• Strong Knowledge of Managed Care Payors.
• Requires interpretation of payor contracts for appropriate appeal rights.
• A strong background in Long Term Acute Care (LTAC) and Inpatient Rehabilitation Facility (IRF) criteria.
• Must be able to diplomatically articulate communications, interpret and explain complex information, and comprehend written, verbal and electronic communication.
• Strong problem-solving skills with effective time management.
• Strong organizational skills to maintain awareness of appeal timelines.
• Self-starter with strong analytical skills and attention to detail.

About Us

AMG is a hospital system committed to our patients, our people, and to the pursuit of healing. As a Top-5 Post-Acute hospital system, we’re known for excellence, integrity, community, and compassion.

Our mission is to return patients to their optimal level of well-being in the least restrictive medical environment. We accomplish this through a multi-disciplined approach that includes aggressive clinical and therapeutic interventions, as well as family involvement. Our high staff to patient ratio ensures individualized attention. Our nurses, therapists, and physicians work with each patient to obtain the best possible outcomes.

Acadiana Management Group, LLC is an equal opportunity employer.