HCA, Hospital Corporation of America Appeal Team Lead in Nashville, Tennessee
Job Summary – The Appeals Team Lead is responsible for performing daily appeals follow-up, monitoring denial trends/issues and assisting the Appeals Manager with training of the appeals department. Supervisor –Appeals Manager Supervises – N/A Duties (included but not limited to): • Provides introductory and ongoing training and education to all Appeals staff to ensure that policies and procedures are followed • Meets with the Manager regularly to effectively communicate and resolve issues, set and prioritize goals and improve processes • Assists with staff communication, providing updates, resolving issues, setting goals and maintaining standards, including performing QA reviews for staff • Maintains established departmental policies and procedures, objectives, patient and customer service policies • Assists with payroll activities for team members (i.e. edit sheets) • Assists manager with development and implementation of project and department action plans • Monitors insurance denials by running appropriate reports and contacting insurance companies to resolve claims denied for clinical reasons • Identifies coding or clinical documentation issues and work to correct the errors in a timely manner • Identifies problem accounts and/or trended issues and escalates as appropriate • Updates the patient account record to identify actions taken on the account • Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement” • Performs other duties as assigned
KNOWLEDGE, SKILLS & ABILITIES • Organization - proactively prioritizes needs and effectively manages resources • 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 • PC skills - demonstrates proficiency in Microsoft Office applications and others as required • Leadership - guides individuals and groups toward desired outcome by providing training, advice and feedback to assist/support employees in achieving established performance standards • Tactical execution - assist in monitoring operational processes and making recommendations for changes/adjustments as needed during the implementation or change to new products or processes • Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems • Basic skills - demonstrates ability to organize, perform and track multiple tasks accurately in short timeframes, have ability to work quickly and accurately in a fastpaced environment while managing multiple demands, ability to work both independently and collaboratively as a team player, adaptability, analytical and problem solving ability and attention to detail and 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 EDUCATION High School diploma or GED required. EXPERIENCE • At least one year of related experience required.
Job: *Finance Acctg Billing Claims & Revenue
Title: Appeal Team Lead
Location: Tennessee-Nashville-PAS - Nashville
Requisition ID: 08942-147715