Appeals Analyst - Experian Health - Remote

At Experian Health our employees can shape more than products they shape the future of U.S. healthcare. Experian Health is a pioneer for innovations leading the way in revenue cycle management identity management patient engagement and care management for hospitals physician groups labs pharmacies and other riskbearing entities.

The Appeals Analyst will report to the Client Organization. You will monitor contractual allowances analyze and pursue appeal opportunities with payers and networks and report appeals performance.

Youll have the opportunity to:

• Implement processes for identifying underallowed claims using Experian Health Contract Manager Product and other available tools
• Review and analyze EOBs for identified underallowed claims
• Verify applicable contract as dictated by operational procedures: reviewing EOB messages
• Review patient ID card verifying member information for managed care plans
• Batch appeals by payer or network by CPT/HCPCS code combination by error type or by provider
• Compile and submit appeals and monitor for proper reimbursement
• Utilize Contract Manager application to track appeals and appeal outcomes
• Establish and cultivate contacts in payer or network offices
• Track contractual billing registration and posting errors and provide feedback to Appeals Manager
• Participate in meetings to discuss ongoing trends and issues regarding the administration of managed care contracts
• Maintain the strict confidentiality required for medical records and other data
• Participate in professional development efforts to ensure currency in managed care reimbursement trends

Qualifications :

• 2 years experience working with managed care claims and appeals for health care professional services (physicians and other health care professionals)
• 1 years experience with a healthcare contract manager application
• 2 years experience with healthcare professional services billing (physicians and related health care professionals) and reimbursement environment
• Knowledge of major types of practice management system (PMS) and EOB imaging systems with experience working with at least one industry leading PMS and of networks IPAs MSOs HMOs PCP and contract affiliations.as well as managed care contracts and compliance.

Benefits/Perks:

• Great compensation package and bonus plan
• Core benefits including medical dental vision and matching 401K
• Flexible work environment ability to work remote
• Flexible time off including volunteer time off vacation sick and 12paid holidays

Additional Information :

Our uniqueness is that we celebrate yours. Experians culture and people are important differentiators. We take our people agenda very seriously and focus on what matters; DEI work/life balance development authenticity collaboration wellness reward & recognition volunteering... the list goes on. Experians people first approach is awardwinning; Worlds Best Workplaces 2024 (Fortune Top 25) Great Place To Work in 24 countries and Glassdoor Best Places to Work 2024 to name a few. Check out Experian Life on social or our Careers Site to understand why.

Experian is proud to be an Equal Opportunity and Affirmative Action employer. Innovation is an important part of Experians DNA and practices and our diverse workforce drives our success. Everyone can succeed at Experian and bring their whole self to work irrespective of their gender ethnicity religion colour sexuality physical ability or age. If you have a disability or special need that requires accommodation please let us know at the earliest opportunity.

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Remote Work :

Yes

Employment Type :

Fulltime