Insurance Appeals Staff
Full Time, 80 Hours Per Pay Period, Day Shift
Covenant Health Overview:
Covenant Health is the region’s top-performing healthcare network with 10 hospitals, 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 integrated healthcare delivery system and the area’s largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes “Best Employer” seven times
This position provides direction for the Financial Services staff with regard to clinical and medical necessity insurance denials. 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, Patient Account Representatives and external vendors as it relates to department operations.
Recruiter: Kathleen Rice || email@example.com || (865) 835-3727
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. Preference may be given to individuals possessing an Associate’s degree in a directly-related field from an accredited college or university.
Minimum Experience: Three (3) or more years of experience in hospital billing or insurance pre-certification required; prefer one (1) or more years insurance appeals experience.
Licensure Requirements: None.
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