Experience with adrs post payment audits and appeals
Jupiter Health Outpatient Services Inc is seeking a part-time HIM Appeals Specialist to support revenue cycle management and appeals processes in healthcare. The ideal candidate will have at least two years of experience in acute care healthcare and a solid understanding of medical billing, coding, and regulations
Job Summary
The HIM Appeals Specialist is responsible for monitoring daily ADR, RAC, and other Third-party requests while researching record requests to determine reasons for denials.
This role requires coordinating record processing, investigating NCD/LCD regulations for medical necessity, and developing tools to prevent future denials.
Jupiter Medical Center is ranked #1 for Safety, Quality, and Patient Satisfaction and is the only hospital in the region to receive a 4-star rating from CMS.
Matching Summary
Match Score: 85
Jupiter Health Outpatient Services Inc is seeking a part-time HIM Appeals Specialist to support revenue cycle management and appeals processes in healthcare. The ideal candidate will have at least two years of experience in acute care healthcare and a solid understanding of medical billing, coding, and regulations.
Skills & Requirements
Must-have
2 plus years acute care healthcare experience
Knowledge of ICD10 CPT HCPCS billing requirements
Experience with ADRs post payment audits and appeals
Nice-to-have
Ability to present data to small groups
Detail oriented multi-task and meet deadlines
Proficiency in Windows PDF tools and Excel
Key Requirements
Associate or bachelor's degree required
2 plus years Hospital Revenue Cycle experience
Familiarity with Government and Third-Party payor Regulations