Appeal Resolution Supervisor supervises a team responsible for the processing of appeals. Assigns and prioritizes cases. Being an Appeal Resolution Supervisor responds to and resolves escalated issues. Coaches and trains team in the utilization of industry standards and best practices. Additionally, Appeal Resolution Supervisor requires a bachelor's degree. Typically reports to a manager. The Appeal Resolution Supervisor supervises a small group of para-professional staff in an organization characterized by highly transactional or repetitive processes. Contributes to the development of processes and procedures. To be an Appeal Resolution Supervisor typically requires 3 years experience in the related area as an individual contributor. Thorough knowledge of functional area under supervision. (Copyright 2024 Salary.com)
DEFINITION:
Denials and Resolution Analyst is under the supervision of one of the MedAccounts Service Supervisors. The Denials and Resolution Analyst is responsible for follow-up and monitoring under-payments from Third party payers. Responsible for data collection and analysis regarding specific Provider and/Facility Inquiries, Disputes and/or Appeals. Develops necessary policies and procedures and oversees quality assurance measures related to Provider and Hospital Disputes.
PREFERRED QUALIFICATIONS:
Must have good organizational skills, reading, writing and proven communication skills.
Proficient in Excel.
Must have 2 years of general medical office experience.
Prefer 2 year of hospital/medical office billing and collections or can demonstrate an understanding of hospital/physician billing and collections.
College degree preferred.
High School Graduate with excellent organizational skills, ability to work independently and stay on task,
Ability to learn and understand billing protocol and reimbursement issues, ability to maintain accurate and detailed charts/notes in the company system.
2 years formal education in business or equivalent experience.
Must have at least 2 years of a Medical Office/Hospital billing setting.
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