Clinical Appeals Specialist RN Team Lead ATL WFH (Parallon) career at Shared Services - Atlanta in Norcross

Shared Services - Atlanta is in need of Clinical Appeals Specialist RN Team Lead ATL WFH (Parallon) on Thu, 16 May 2013 15:24:44 GMT. JOB TITLE: Clinical Appeals Specialist Team Leader GENERAL SUMMARY OF DUTIES â€" Assists Clinical Appeals Manager with training of the appeals department. Performs daily appeals follow-up and monitors denial trends and issues. SUPERVISOR â€" Clinical Appeals Manager SUPERVISES - N/A DUTIES INCLUDE BUT ARE NOT LIMITED TO: · Provides introductory and ongoing training and education to Clinical...

Clinical Appeals Specialist RN Team Lead ATL WFH (Parallon)

Location: Norcross Georgia

Description: Shared Services - Atlanta is in need of Clinical Appeals Specialist RN Team Lead ATL WFH (Parallon) right now, this career will be placed in Georgia. Further informations about this career opportunity kindly see the descriptions. JOB TITLE:
Clinical Appeals Specialist Team Leader

GENERAL SUMMARY OF DUTIES

â€" Assists Clinical Appea! ls Manager with training of the appeals department.

Performs daily appeals follow-up and monitors denial trends and issues.

SUPERVISOR

â€" Clinical Appeals Manager

SUPERVISES

• N/A

DUTIES INCLUDE BUT ARE NOT LIMITED TO:
·

Provides introductory and ongoing training and education to Clinical Appeals staff to ensure that policies and procedures are followed

·

Meets with the Manager regularly to effectively communicate and resolve issues, set and prioritize goals and improve processes

·

Assists with staff communication, providing updates, resolving issues, setting goals and maintaining standards

·

Maintains established departmental policies and procedures, objectives, patient and customer service policies

·

Assists with payroll activities for team members (i.e., time cards, edit sheets)

·

Assists manag! er with development and implementation of project and departme! nt action plans

·

Monitors insurance denials by running appropriate reports and contacting insurance companies to resolve claims denied for clinical reasons

·

Identifies coding or clinical documentation issues and work to correct the errors in a timely manner.

·

Identifies problem accounts and escalates as appropriate

·

Updates the patient account record to identify actions taken on the account.

·

Works with guarantors to secure payment on account balances denied for clinical reasons

·

Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”

·

Performs other duties as assigned

Qualifications

EDUCATION

·

Associate’s Degree in Nursing required

·

Prior supervisory experience preferred

EXPERIENCE

·

At least one year case m! anagement experience required

·

Relevant education may substitute experience requirement

CERTIFICATE/LICENSE

-

Current

State

Registered Nurse
- .
If you were eligible to this career, please email us your resume, with salary requirements and a resume to Shared Services - Atlanta.

If you interested on this career just click on the Apply button, you will be redirected to the official website

This career starts available on: Thu, 16 May 2013 15:24:44 GMT

Apply Clinical Appeals Specialist RN Team Lead ATL WFH (Parallon) Here