Appeal Resolution Specialist jobs in Utah

Advanced Health Care (AHC) is an innovative health care company focused on delivering 5-star services and exceptional patient outcomes. AHC operates short-term transitional rehabilitation facilities, home health care agencies, and hospice services throughout the country. For more information about Advanced Health Care visit www.ahcfacilities.com.

AHC is a portfolio company of Larry H. Miller Group of Companies (LHM Group). Headquartered in Sandy, Utah, the LHM Group is a privately-owned family business with operations located across the western United States. For more information about the LHM Group, visit www.lhm.com.

Summary

A Claims Resolution Specialist ensures the outstanding revenue for services provided by home health and hospice agencies is collected and reimbursed appropriately. This position is a partially remote position; employees will work from home 3 days a week and required to be in the office 2 days a week.

Responsibilities and Duties

• Obtaining claim status from insurance plans via phone and/or online portals
• Reviewing medical insurance claims for resolution and payment in a timely manner for maximum reimbursement
• Analyzing remittance advices to ensure accurate and timely posting of rejections, payments, and contractual adjustments
• Posting payments received and adjudicating accounts
• Maintaining a working knowledge of payer practices and reimbursement methodologies
• Becoming a subject matter expert in assigned A/R responsibilities
• Researching, compiling, and responding to documentation requests from insurance carriers
• Establishing and maintaining positive working relationships with agencies
• Support AHC culture by promoting “Friendly, Positive, and Focused on Excellence"
• All other duties as assigned

Competencies:

To perform the job successfully, an individual should demonstrate the following competencies to perform the essential functions of this position.

• Proficient in mathematical, verbal, written, and computer skills, as well as reasoning ability
• Excellent communication, organization, and follow-up skills
• Ability to handle multiple assignments simultaneously
• Attention to detail and the ability to work independently

Job Qualifications:

• Previous medical accounts receivable experience required
• Knowledge of home health operations preferred

Physical Requirements:

• Regularly required to walk, sit, stand, bend, reach, lift, and move about
• Ability to communicate effectively, both orally and in writing.
• To perform other duties as required

Note: The need may arise to revise, supplement, or rescind portions of this job description, and Advanced Health Care reserves the right to do so at any time. Employee shall be required to meet the qualifications and perform the duties of any revised job description.

AHC provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Job Type: Full-time

Pay: From $18.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee discount
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday
• No weekends

Work setting:

• Hybrid work
• Office

Experience:

• medical accounts receivable: 1 year (Required)

Work Location: Hybrid remote in Farmington, UT 84025