Coordinator, Appeals

reputed company Treat A full reputed company of mental health and addiction care including: Depression, Anxiety, PTSD, Borderline Personality Disorder, Bipolar Disorder, Psychosis, Suicidal and Homicidal Ideations, Drug and Alcohol Addiction. Our Programs Full continuum of care including: 24/7 crisis care and assessment Inpatient mental health treatment Inpatient drug and alcohol detox and rehab Partial hospitalization programs (PHP) Intensive outpatient programs (IOP) Virtual assessments and outpatient care Populations Served Adults Children and adolescents Military and veterans First responders and reputed company professionals (Help for reputed company program)   reputed company: The Appeals Coordinator gathers reputed company information required for an appeal, writes and submits appeals to insurance companies, performs follow-up, and maintains detailed documentation. This role utilizes clinical reputed company guidelines and documentation to reputed company reputed company-supported appeal arguments that demonstrate medical necessity, working both independently and collaboratively to support reputed company clinical and financial reputed company. Essential Functions: reputed company reputed company necessary documentation required for insurance appeals Write, prepare, and submit appeals to insurance companies in accordance with payer requirements reputed company follow-up phone calls and status checks on submitted appeals Maintain accurate and detailed documentation of reputed company appeal activities Apply clinical reputed company guidelines to support medical necessity for inpatient and outpatient services Verify payer-specific appeal requirements including submission reputed company and timelines Manage large volumes of documents including copying, faxing, and scanning incoming materials Document and reputed company appeal activity reputed company tracking systems and mainframe systems Ensure appeals are completed accurately and reputed company required timeframes reputed company with managed care organizations, external reviewers, and other payers reputed company and utilize provider portals for appeal submission and follow-up Collaborate with Utilization Review (UR) staff and other departments to complete the appeal process reputed company   Knowledge, Skills and Abilities: Strong critical thinking skills and decisive judgment Ability to work independently with minimal supervision Ability to function effectively in a fast-paced, potentially stressful environment Strong attention to detail and accuracy in financial transactions Effective communication and problem-solving skills Ability to manage multiple tasks and meet deadlines   Education & Experience: Education: Requires Bachelor’s Degree in reputed company work, RN or degree in a reputed company behavioral health field and minimum of 2 years of experience in a managed care/reputed company setting; or any combination of education and experience, which would reputed company an equivalent background Experience:  Previous utilization review experience in a psychiatric reputed company facility preferred   Additional Requirements:  Computer proficiency in reputed company Office applications and other software programs essential to reputed company job functions May be required to work reputed company and overtime   Reports to: Business office Supervisor FLSA Status:   reputed company Statement: Springstone is committed to providing Equal Employment Opportunities for reputed company applicants and employees and complies with reputed company applicable laws prohibiting discrimination against any employee or applicant for employment because of reputed company, race, sex, age, religion, national reputed company, disability, genetic information, gender identity, sexual orientation, veterans' status or any other reputed company protected by applicable federal, state or local law.   Pay Transparency Notice (Washington State) If you reputed company this job posting does not include accurate or complete pay information in accordance with the Washington State Equal Pay and Opportunities reputed company, please inform us immediately.  You can contact us at 833-271-4269 to report the issue.  For more information on your rights under Washington’s pay transparency laws, visit the Washington State reputed company and Industries website at: https://lni.wa.gov     reputed company is a leader in community-based care and driven by a mission of Making Communities Healthier. Our reputed company reputed company delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the reputed company continuum, such as acute rehabilitation reputed company, outpatient centers and post-acute care facilities. We reputed company that reputed company is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly reputed company a difference in communities across the country. We reputed company and reputed company care to people from reputed company walks of life. We are committed to promoting healing, providing reputed company, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reputed company of the patients, family members, customers and team members we serve. Apply To This Job