Insurance Appeals Associate
Full Time, 80 Hours Per Pay Period, Day Shift
Covenant Health Overview:
Covenant Health is East Tennessee’s top-performing healthcare network with 10 hospitals and over 85 outpatient and specialty services, and Covenant Medical Group, our area’s fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned, not-for-profit healthcare system and the area’s largest employer with over 11,000 employees.
Covenant Health is the only healthcare system in East Tennessee to be named six times by Forbes as a Best Employer.
This position has the responsibility of building patient accounts in the denials management system and performing timely follow-up with regard to clinical and medical necessity insurance appeals. Analyzes all correspondence regarding insurance denials for the Revenue Integrity Auditor to take appropriate action. Prepares necessary documentation for insurance appeals process, ensuring timely follow through. Processes claim adjustments for leadership approval and posts payments as necessary. Maintains integrity of denials management database for accurate statistical and educational reporting. Provides feedback to Revenue Integrity Auditors and Patient Account Representatives as it relates to department operations.
Minimum Education: None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED.
Minimum Experience: Two (2) years of experience in hospital billing or insurance pre-certification required; Must be familiar with healthcare billing and insurance regulations such as those required by Medicare, Medicaid or Commercial payers. Computer experience is required.
Licensure Requirements: None.
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