Appeals Processing Coordinator

Job Overview Provides operational support to Revenue Cycle in areas of billing and appeals. Tracks all appeals, facilitates timely submission, and performs record keeping. Responsibilities Partner with Appeals Coordinators, Utilization Review, and Patient Accounts Managers to ensure payor appeals packages are created accurately for timely submission. Review appeals packages to ensure accuracy and completeness. Support and help coordinate documentation for administrative law hearing/settlement submissions. Provide continuous analysis of denials and operational support for appeals. Identify payor denial trends and communicate issues and outcomes to appropriate areas. Assist Process Improvement Specialists, Appeal Coordinators, Utilization Review, department managers, and director to identify opportunities for improvement. Monitor and provide summary-level reporting to Appeal Coordinators and department leadership regarding critical functions of the area. Assemble appeals record in correct order, verifying that all materials belong to named patient and placing record in correct folder and sequence. Enter appeals statistics and update spreadsheets daily and monthly by payor to track and report volume, timeliness of appeals sent, and status. Ensure appeals are received by appropriately following up as needed. Facilitate obtaining medical records as needed to ensure appeals submission. Participate in training to ensure continuous improvement in appeals process. Assist with other tasks, e.g., loose filing, printing, and mailing. Qualifications & Requirements 1 year of experience in insurance billing or collections, with general knowledge of hospital business office functions. Preferred: 2 years of experience in insurance billing and/or collections with a general knowledge of hospital business office functions. Knowledge of managed care billing and key Children’s Healthcare of Atlanta patient accounting applications (e.g., EPIC Resolute, Dentrix Dental, Clearinghouse). High school diploma or equivalent. No professional certifications required. Knowledge, Skills, and Abilities Exceptional instruction skills with attention to detail. Strong written and verbal communication skills. Ability to assess workload and prioritize. Medical terminology knowledge. EEO Statement Children’s Healthcare of Atlanta is an equal opportunity employer committed to providing equal employment opportunities to all qualified applicants and employees without regard to race, color, sex, religion, national origin, citizenship, age, veteran status, disability or any other characteristic covered by applicable law. Location 1575 Northeast Expy NE, Atlanta, GA #J-18808-Ljbffr