Global Medical Response, Inc.

Title
Coordinator Appeals Denials in Saint Louis, MO
Requisition ID
2021-14455
Location
US-MO-Saint Louis
Employment Type
Regular Full-Time

More Information about this Job

Can be based anywhere in the US

 

The Medical Appeals and Denials Coordinator assists the Medical Appeals and Denials team by monitoring Medicare Administrative Contractor (MAC) portals and retrieving documents that require a response from GMR.  This individual will help with the tracking of these requests and responses and assist the team with processing appeals as time allows.

 

Essential Duties and Responsibilities:

  • Access, monitor and retrieve documents from various MAC portals
  • Memorialize documents requiring production in an Excel spreadsheet and forward Excel spreadsheet to billing agent for processing
  • Assist with reviewing documents prior to forwarding to a MAC or other payor to ensure all information is legible and responsive to the request
  • Assist with contacting operations, hospitals or other care providers when additional documentation is needed to support the billing and appeal process
  • Prioritize and organize a high volume of work and meet deadlines
  • Recommend efficiencies to overall departmental processes
  • Complete required reports and assist with special projects as assigned
  • Work under the oversight of the Compliance Department specific to government audits
  • Adhere to all company policies and procedures
  • Adherence to and compliance with information systems security is everyone’s responsibility. It is the responsibility of every computer user to know and follow Information Systems security policies and procedures. Attend Information Systems security training, when offered. Report information systems security problems

 

Minimum Qualifications:

  • 1+ years previous hands-on medical billing experience in a fast-paced medical billing environment
  • Experience with ambulance coding and appeals is highly desirable

Education/Licensing/Certification:

  • High School diploma 
  • Certified Ambulance Coder (CAC) preferred 

Knowledge and Skills:  

 

  • Strong knowledge of HCPCS and ICD-10 required; Knowledge of Correct Coding Initiative; prior experience navigating payor and clearinghouse websites
  • Computer experience in Medical billing software programs
  • Involvement with Medicare, Medicaid, HMO, and PPO appeals process and results
  • Direct insurance company contacts and adjudication procedures knowledge
  • Advanced verbal and written communication skill required
  • The ability to handle a very high volume of work with speed and accuracy is essential

 

 

#GMR_Corp

EEO Statement

Global Medical Response and its family of companies are an Equal Opportunity Employer including Veterans and Disabled

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