Contract Appeals Analyst, United Urology Group, Owings Mills, MD
United Urology Group -
Owings Mills, MD,
US
Contract Appeals Analyst
Date Posted: 2024-06-18
Job description
Job Details
Job Location
UUG Corporate - Owings Mills, MD
Position Type
Full Time
Education Level
4 Year Degree
Salary Range
$24.00 - $30.00 Hourly
Travel Percentage
Limited, if any
Job Category
Revenue Cycle Management
Description
Are you interested in making a difference in patient care? Learn about our unique culture of respect, growth, innovation, the best patient care, and how we give back to the community.
At United Urology Group, our employees are at the heart of our mission and have incredible opportunities to impact our patients' lives with their urologic care.
United Urology Group is regarded as the leading urology network in the country. Our Affiliates include Chesapeake Urology, Arizona UrologyPhoenix & Scottsdale, Arizona UrologyTucson, Colorado Urology, and Tennessee Urology.
Position Summary:
The Contract Appeals Analyst is responsible for monitoring contractual allowances, analyzing, and pursuing appeal opportunities with payers and networks, and reporting appeals performance.
Primary Duties & Responsibilities:
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the employee for this job. Duties, responsibilities, and activities may change at any time, with or without notice.
Qualifications
Qualifications:
Knowledge, Competencies & Skills:
Tech Requirements for the Job:
Direct Reports:
Travel:
Physical Requirements for the Job:
Equal Opportunity Employer: United Urology Group and its affiliate practices are an equal opportunity employer. We do not discriminate based on race, color, religion, age, sex, national origin, disability, veteran status, or sexual orientation.
The successful candidate(s) for any UUG position will be subject to a pre-employment background check.
Actual compensation offered to candidates is based on work experience, education, and/or skill level.
Job Location
UUG Corporate - Owings Mills, MD
Position Type
Full Time
Education Level
4 Year Degree
Salary Range
$24.00 - $30.00 Hourly
Travel Percentage
Limited, if any
Job Category
Revenue Cycle Management
Description
Are you interested in making a difference in patient care? Learn about our unique culture of respect, growth, innovation, the best patient care, and how we give back to the community.
At United Urology Group, our employees are at the heart of our mission and have incredible opportunities to impact our patients' lives with their urologic care.
- We foster a culture that thrives on compassion, teamwork, integrity, and diversity, all of which start with our staff!
- We deliver a cohesive approach to urologic care that provides patients with access to experienced specialists, a superb team of healthcare professionals, and the most advanced technology for patient treatments and therapies.
- We offer competitive salaries and a great work/life balance: enjoy your weekends!
- UUG offers outstanding benefits, including tuition reimbursement, health, dental, and vision insurance, corporate discounts, and much more!
United Urology Group is regarded as the leading urology network in the country. Our Affiliates include Chesapeake Urology, Arizona UrologyPhoenix & Scottsdale, Arizona UrologyTucson, Colorado Urology, and Tennessee Urology.
Position Summary:
The Contract Appeals Analyst is responsible for monitoring contractual allowances, analyzing, and pursuing appeal opportunities with payers and networks, and reporting appeals performance.
Primary Duties & Responsibilities:
- Implements process for identifying under-allowed claims using Contract Management software and other available tools.
- Reviews and analyzes EOBs for identified under-allowed claims.
- Verifies the applicable contract by reviewing EOB messages, reviewing patient ID cards, and verifying member information, as dictated by operational procedures.
- Uses feedback and experience to refine communication skills and tools for use in preparing written and telephone appeals.
- Batches appeals by payer or network, by CPT/HCPCS code combination, by error type, or by provider.
- Compiles and submits appeals and monitors for proper reimbursement.
- Uses Contract Management to track appeals and recoveries.
- Establishes and cultivates helpful and effective contacts in payer or network offices.
- Establishes follow-up protocol with payers and networks.
- Prepares monthly performance statistics regarding appeals and recoveries.
- Monitors and tracks contractual, billing, registration, and posting errors and provides continuous feedback to the AR Manager.
- Participates in meetings to discuss ongoing trends and issues regarding the administration of payer contracts.
- Maintains the strict confidentiality required for medical records and other data.
- Participates in professional development efforts to ensure currency in reimbursement trends.
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the employee for this job. Duties, responsibilities, and activities may change at any time, with or without notice.
Qualifications
Qualifications:
- Bachelor's degree or greater in a related field or equivalent education and experience.
- Minimum of two (2) years' experience working with claims, denials, and appeals for health care professional services (physicians and other health care professionals).
- Experience in a production environment is desirable, but comfort in such an environment is essential.
- Experience with digital office equipment, including scanners and fax machines.
Knowledge, Competencies & Skills:
- Advanced knowledge and PC skills, with proficiency in utilizing Microsoft office products (Word, Excel, Outlook, PowerPoint, etc.)
- Knowledge of the health care professional services billing (physicians and related health care professionals) and reimbursement environment.
- Knowledge of major types of practice management systems (PMS) and EOB imaging systems, with experience working with at least one industry-leading PMS highly desirable.
- Knowledge of both professional and institutional insurance billing and how multiple procedure discounts/modifiers impact reimbursement.
- Knowledge of medical terminology.
- Knowledge of networks, IPAs, MSOs, HMOs, PCP, and contract affiliations.
- Knowledge of managed care contracts and compliance.
Tech Requirements for the Job:
- High-speed, reliable internet connection to ensure uninterrupted communication and access to necessary systems and tools.
- Quiet and private work environment to maintain the confidentiality of patient information and minimize background noise during calls.
- Proficiency in using remote collaboration tools, such as video conferencing software, instant messaging platforms, and customer relationship management systems.
- Compliance with all security and privacy policies and protocols, including safeguarding patient information and maintaining HIPAA compliance.
Direct Reports:
- N/A.
Travel:
- Must have the ability & willingness to travel to other sites as necessary within a geographic region.
Physical Requirements for the Job:
- Regularly required to sit and stand for extended periods.
- Involves standing, sitting, walking, bending, stooping, and twisting.
- Requires full range of body motion, including manual and finger dexterity and eye-hand coordination.
- Frequently lift or move up to 10 pounds and occasionally lift or move up to 25 pounds.
Equal Opportunity Employer: United Urology Group and its affiliate practices are an equal opportunity employer. We do not discriminate based on race, color, religion, age, sex, national origin, disability, veteran status, or sexual orientation.
The successful candidate(s) for any UUG position will be subject to a pre-employment background check.
Actual compensation offered to candidates is based on work experience, education, and/or skill level.