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Provider Non-Contracted Appeals And Claims Analyst

Company

Mediant Health Resources
Address Los Angeles, CA, United States
Employment type FULL_TIME
Salary
Category IT Services and IT Consulting,Hospitals and Health Care
Expires 2023-07-02
Posted at 1 year ago
Job Description


Location: Los Angeles, CA


Duration: 3 months, contract to hire


Responsibilities


  • Attention to Detail
  • Bachelor’s Degree in related field, a plus
  • High School Diploma required
  • Understanding of different payment methodology such as Medicare PPS (MS-DRG, APC, etc.), Medicare Physicians fee schedule, Per Diem, etc.,
  • Understanding of Division of Financial Responsibility on how they apply to claims processing
  • Proven problem-solving skills and ability to translate knowledge to the department
  • Familiarity with billing and coding edits, coordination of benefits, MA Organization, Determination, Appeals and Grievance procedures
  • Working knowledge of medical terminology, standard coding and reference publications, CPT, HCPC, ICD-9, ICD-10, DRG, etc.
  • Excellent verbal and written communication skills
  • 3+ years’ experience processing Medicare Advantage provider appeals from all types of providers (hospitals, physicians, ancillary)
  • 3+ years’ experience in examining all types of medical claims, preferably Medicare Advantage claims
  • Working knowledge of Microsoft Office Programs (Outlook, Excel and Word)
  • Working knowledge of claims processing systems (EZCAP preferred)
  • Strong Organizational Skill and ability to multitask