APPEALS SPECIALIST - Frisco, TX

Currently, Tenet is seeking an Appeals Specialist for the Texas Regional Business Office located in FRISCO, TX. As an Appeals Specialist, you will be responsible for the following:

Drafts technical appeal letters based on type of technical denial using system applications.
Prioritizes technical appeal requests based on contractual appeal timeframes.
Coordinates activities with clerical support. Can navigate in patient accounting systems to determine various aspects of account detail necessary for eDM data entry management i.e. Invoice, T&C, AR Inquiry System screen.
Proficient in eDM data entry and navigation ensuring the accuracy of all data entered into eDM. Ensures documentation is clear and concise for appropriate outcome including documentation in eDM.
Meets productivity standards on a number of technical appeals processes per day.
Knowledge of payor authorization guidelines in an effort to determine if appeal requires a clinical review or can be handled from a technical perspective.
Adheres to all federal law as and company policy regarding confidentiality of privileged patient information. REQUIREMENTS

High school diploma or equivalent.
Some general business courses desirable.
3+ years working for the County Welfare Office engaged in eligibility determination, and/or 3+ years working for the Social Security Administration engaged in disability determination, and/or 3+ years as a patient advocate or equivalent.
Business office related experience: clerical, collections, support, billing.
Personal computer experience required including a working knowledge of patient accounting systems, Microsoft Office, Word, Excel, and web based eTenet computer applications.
Strong communication and interpersonal skills. Ability to work in a high volume environment at a fast pace, can multi-task, has strong analytical and math skill, and possesses good verbal and writing skills.