Job Summary:***The Appeals Specialist is responsible for performing end to end tasks for technical appeals.**Responsibilities**:- Triage incoming inventory for the Appeals team, validating appeal criteria is met- Compose technical denial arguments for reconsideration, including both written and telephonically- Identify contract protection that can be leveraged to overturn denials.- Overcome objections that prevent payment of the claim and gain commitment for payment through concise and effective appeal argument- Identify problem accounts/processes/trends and escalate as appropriate- Utilize effective documentation standards that support a strong historical record of actions taken on the- Ability to perform basic math to ensure accurate statement of accounts receivable- Meet the productivity and quality standards of the organization- Timely completion and comprehension of all educational requirements- Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"Skills and Experience:- **Communication** - communicates clearly and concisely, verbally and in writing. This includes utilizing proper punctuation, correct spelling and the ability to transcribe accurately.- ** Customer orientation** - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations- ** Interpersonal skills** - able to work effectively with other employees, patients and external parties- ** Policies & Procedures** - demonstrates knowledge and understanding of organizational policies, procedures and systems- ** Technical skills**:- Professional presentation skills needed to represent facilities in legal- ** Basic skills** - able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately- ** Clinical** **skills **- **ability to read and interpret medical records a plus- ** Education** -High School Diploma- ** English** - Written and verbal communication skills in English (English Level B2).About Auxis:Auxis prioritizes employee growth and development to help you advance your career. Auxis' culture empowers you to be your best in the interest of a common team goal. We are constantly striving to improve our culture and environment and have invested in tools to continue to have better visualization of the pulse of our organization.- Benefits_- Health benefits including medical, vision, and dental.- Transportation subsidy- Asociacion Solidarista- Training and development programs- Employee recognition program- Paid time off and family paid leave- Paid day off for your birthday!
