Physician Billing Appeals Specialist

York, PA | Clerical and Administrative | Tracking Code: 59579

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Position Summary:

 

General Summary:
Under general supervision, monitors contractual allowances and analyzes and pursues appeal opportunities with payers and networks. Represents the System in a professional manner, using good customer service practices in the performance of all duties.

Duties and Responsibilities:

 1 Uses the Experian CM application to identify variances and track appeals & recoveries.
2 Implements process for identifying under and over allowances on claims.
3 Reviews and analyzes EOBs for identified under and/or over allowances.
4 Compiles and submits appeals by written appeal, telephone appeal, online appeal or by batch appeal to provider rep.
5 Establishes appropriate contacts and follow up protocol with payers and networks.
6 Maintains contracted rates in the Experian CM application.
7 Discusses ongoing trends and issues regarding payment variances with management and staff.
 

 

Required Skills

 

Minimum Education             High School or G.E.D.

 

Minimum Experience            2 - 3 years ICD10 & CPT   coding; insurance knowledge; computer skills  Excellent communication/interpersonal skills; Attention to detail:

 

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Why WellSpan Health?

WellSpan Health is an integrated health system that serves the communities of central Pennsylvania and northern Maryland. The organization comprises a multispecialty medical group of more than 1,500 physicians and advanced practice clinicians, a regional behavioral health organization, a home care organization, eight respected hospitals, more than 19,000 employees and 170 patient care locations. WellSpan is a charitable, mission-driven organization committed to exceptional care for all, lifelong wellness and healthy communities. We are committed to transforming the health of the communities we serve and to educating the next generation of clinicians, staff and leaders.

Employment Benefits

  • Sign-on incentives for new employees (click here for details)
  • Medical, dental and vision insurance
  • Life and accidental death insurance
  • Supplemental life insurance
  • Retirement savings plan
  • Paid time off (PTO)
  • PTO bridging
  • Short-term disability
  • Educational assistance
  • Forgivable loan
  • Flexible spending
  • Credit union
  • Employee recreational activities
  • Childcare
  • Complimentary medicine discounts

Diversity & Inclusion

Know, Respect, Include

WellSpan Health believes that diversity includes all the human characteristics that make each of us similar as well as different. We strive to make every person feel welcomed, respected and valued, while creating a safe and inclusive environment where we all have the individual freedom to express our uniqueness in a respectful manner.

WellSpan Health is an equal opportunity employer. Employment selection and related decisions are made without regard to sex, race, age, disability, religion, national origin, color or any other protected class. WellSpan Health does, however, have a tobacco-free/nicotine-free hiring policy.

Quality of Life

Founded in 1741, the city of York is considered by many as the first capital of the United States. The Articles of Confederation were signed by the Second Continental Congress here in 1777. Its beautifully restored historic district is an architectural treasure. While York retains its farming and manufacturing heritage, at its heart York is a thriving cultural community that has attracted creative talent and innovative entrepreneurial investors from across the nation.

Life in York County offers affordable housing, options for higher education, a thriving arts and cultural community, historical attractions, parks and recreational resources, semi-professional baseball team, fine dining and more — within an easy drive of major East Coast cities.

York County residents can find local employment in healthcare, manufacturing, technology, agricultural and service sectors. (Patient population: 445,000)