Appeal Resolution Specialist jobs in Harrisburg, PA

Appeal Resolution Specialist logs, tracks, and processes appeals and grievances. Sets up and maintains case files for each grievance and collects the information required by organizational policies and applicable regulations. Being an Appeal Resolution Specialist conducts research and coordination needed to evaluate, process, respond to, and refer or close appeals. May require an associate degree or equivalent. Additionally, Appeal Resolution Specialist typically reports to a supervisor. The Appeal Resolution Specialist works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be an Appeal Resolution Specialist typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)

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Resolution specialist
  • Select Medical
  • Camp Hill, PA FULL_TIME
  • Overview

    Claims Resolution Specialist

    Starting at $17.50 per hour

    On-Site

    Hybrid Schedule Possible After 90 Day Probationary Period)

    Do you enjoy puzzles and research? Are you results-oriented? If so, our Claims Resolution Specialist position may be a phenomenal career for you within Select Medical! Our dynamic team has the responsibility of resolving outstanding insurance claims so that our patients are not impacted.

    We offer an exceptional employee experience, full-time hours, full benefits, paid training, and advancement opportunities.

    Our team offers flexible, first shift, Monday through Friday schedules. This would include two fifteen minute breaks and one half-hour lunch.

    We allow for casual work attire, jeans are our norm!

    Responsibilities

    Investigate and follow-up on all open balances for accounts that have received a payment or denial, or that are greater than 30 days from billing.

    Contact responsible party to establish reason for non-payment document in system all verbal and written communication relative to open account balance, and institute timely follow-up with responsible party as a result of last contact to assure progress in resolving account with payment.

    • Maintain consistent, productive, and timely follow-up, as often as is needed to collect on the account. Time between account follow up is not to exceed 30 days.
    • Maintain a productivity of 20 to 25 accounts per day. This is subject to change based on volume changes and operational needs.
    • Make outgoing calls to patients, insurance companies and attorneys regarding claim status in order to reduce both outstanding receivables.
    • Regularly communicate with hospital staff and department management on any accounts receivable issues / problematic payor trends.
    • Identify and resolve issues impacting the timely collection of open receivables.
    • Notify database operations of changes or additions to specific payor, plan, contract, address, or other pertinent information as necessary.
    • Meet the expectations and goals for productivity and collections targets as set forth by management.
    • Performs other duties or special projects as assigned.

    Qualifications

    Required :

    • High School Diploma or Equivalent
    • One year of experience (2 years for remote candidates) within a medical billing, medical collecting or claims processing role.

    Preferred :

    • Computer Skills
    • Microsoft Office :
    • Outlook
    • Excel
    • Ability to work with multiple programs simultaneously.
    • Good interpersonal, oral and written communication skills.
    • Previous experience in metrics based role, where production / quality standards are upheld.
    • Time management and organizational skills
    • Proven experience with investigative research.
    • Ability to work independently and as part of team to reach mutually established goals.
    • Attention to detail
    • Flexibility and being open to change
    • This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management.

    Additional Data

    Your benefits as a Claims Resolution Specialist :

    Select Medical strives to provide our employees with a solid work-life balance, as we understand that happy employees have both fulfilling careers and fulfilling lives beyond our doors.

    • An extensive and thorough paid orientation program.
    • Paid Time Off (PTO) and Extended Illness Days (EID).
    • Health, Dental, and Vision Insurance; Life insurance; Prescription coverage.
    • A 401(k) retirement plan with company match.
    • No Required Weekends

    Working Conditions / Physical Demands :

    • Office Environment
    • Hybrid Remote Work Structure
    • Sitting for extended periods of time
    • Ability to lift weight up to 35 lbs.

    Select Medical is committed to having a workforce that reflects diversity at all levels and is an equal opportunity employer.

    Qualified applicants are considered for employment, and employees are treated during employment without regard to race, color, religion, national origin, citizenship, age, sex, sexual orientation, gender identity, marital status, ancestry, physical or mental disability, veteran status, or any other characteristic protected under applicable law.

    Select Medical is an EOE

    Last updated : 2024-04-24

  • Just Posted

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Claims Resolution Specialist
  • Select Medical
  • Camp Hill, PA FULL_TIME
  • Overview Claims Resolution Specialist Starting at $17.50 per hour On-Site (Hybrid Schedule Possible After 90 Day Probationary Period) Do you enjoy puzzles and research? Are you results-oriented? If so...
  • 1 Month Ago

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Claims Resolution/Insurance Claim Follow Up Specialist
  • Cornerstone Adminisystems Inc.
  • New Cumberland, PA FULL_TIME
  • Company Overview Cornerstone Adminisystems, Inc. is an employee-owned company, founded in 1994 with a sole focus on serving the EMS industry. We deliver comprehensive billing and revenue cycle managem...
  • 1 Month Ago

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Appeals Resolution Program Administrator
  • Pennsylvania Employees Benefit Trust Fund
  • Harrisburg, PA FULL_TIME
  • The Pennsylvania Employees Benefit Trust Fund (PEBTF), administrator of health benefits for Commonwealth of Pennsylvania employees and retirees, has an immediate opening for an Appeals Resolution Prog...
  • 25 Days Ago

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Scrub Technician
  • Omni Eye Specialist Pa
  • Chambersburg, PA FULL_TIME
  • Essential Duties and Responsibilities: Duties Maintains a clean and orderly central processing area (e.g., shelves, counters, equipment) Adheres to sterilization process policies and procedures Cleans...
  • Just Posted

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Registered Nurse Practitioner
  • Omni Eye Specialist Pa
  • Chambersburg, PA FULL_TIME
  • Job description Nurse Practitioner Role Scope The Nurse Practitioner provides pre-admissions testing for surgical patients at OOMC Responsible for coordinating pre-op care including H&P’s, and all req...
  • 9 Days Ago

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0 Appeal Resolution Specialist jobs found in Harrisburg, PA area

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Medical Record Evaluator- Expert Witness (709684)
  • TulaRay
  • Harrisburg, PA
  • Job Description Minimum Qualifications Active License issued by the Pennsylvania State Board of Medicine. Certification ...
  • 4/26/2024 12:00:00 AM

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Service Level Agreement /SLA Expert Architect - Location Negotiable
  • Accenture
  • Harrisburg, PA
  • We Are Accenture is a leading global professional services company that helps the worlds leading businesses, governments...
  • 4/25/2024 12:00:00 AM

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Human Resources Expert
  • Roundel
  • York, PA
  • locations 2610 Pleasant Valley Rd, York,PA 17402-9609time type Variableposted on Posted 2 Days Agojob requisition id R00...
  • 4/24/2024 12:00:00 AM

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Field Application Specialist - HammerHead
  • The Toro Company
  • Harrisburg, PA
  • Typical Starting Pay: $80,000-$105,000, plus bonuses. What Can We Give You? Medical, Dental, Vision, 401K Matching up to...
  • 4/23/2024 12:00:00 AM

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Charlotte Tilbury Part-Time Brand Expert
  • Charlotte Tilbury
  • Middletown, PA
  • Charlotte Tilbury is currently recruiting Freelance Brand Experts to join the team. This position will be part of the Ch...
  • 4/22/2024 12:00:00 AM

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Medical Laboratory Scientist MLS Expert - GSACH - Full Time Days
  • Geisinger
  • Pine Grove, PA
  • Job Title: Medical Laboratory Scientist MLS Expert - GSACH - Full Time Days Location: Shamokin, Pennsylvania Job Categor...
  • 4/22/2024 12:00:00 AM

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Medical Laboratory Scientist MLS Expert - GSACH - Full Time Days
  • Geisinger
  • Shamokin, PA
  • Job Title: Medical Laboratory Scientist MLS Expert - GSACH - Full Time Days Location: Shamokin, Pennsylvania Job Categor...
  • 4/22/2024 12:00:00 AM

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Medical Laboratory Scientist Expert - Geisinger Medical Center - Full Time - Days
  • Geisinger
  • Dornsife, PA
  • Job Title: Medical Laboratory Scientist Expert - Geisinger Medical Center - Full Time - Days Location: Danville, Pennsyl...
  • 4/22/2024 12:00:00 AM

Harrisburg (/ˈhærɪsbɜːrɡ/ HARR-iss-burg; Pennsylvania German: Harrisbarrig)[citation needed] is the capital city of the Commonwealth of Pennsylvania in the United States, and the county seat of Dauphin County. With a population of 49,192, it is the 15th largest city in the Commonwealth. It lies on the east bank of the Susquehanna River, 107 miles (172 km) west of Philadelphia. Harrisburg is the anchor of the Susquehanna Valley metropolitan area, which had a 2017 estimated population of 571,903, making it the fourth most populous in Pennsylvania and 96th most populous in the United States. Harr...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Appeal Resolution Specialist jobs
$46,526 to $57,637
Harrisburg, Pennsylvania area prices
were up 1.5% from a year ago

Appeal Resolution Specialist in Colorado Springs, CO
As a Appeals Resolution Specialist, you will work directly with our Shared Service Centerproviding follow up to denied claims.
February 22, 2020
Appeal Resolution Specialist in Fort Smith, AR
Overcome objections that prevent payment of the claim and gain commitment forpayment through concise and effective appeal argument.
February 01, 2020
Appeal Resolution Specialist in Middlesex, NJ
Coordinate the overall process of complaint resolution, responding to all verbal and written complaints from members and/or providers relating to member eligibility and benefits, contract administration, claims processing, utilization management decisions, pharmacy and vision decisions.
January 25, 2020