Appeals Specialist I - Denials

Description

For over two decades, Aspirion has delivered market-leading revenue cycle services. We specialize in collecting challenging payments from third-party payers, focusing on complex denials, aged accounts receivables, motor vehicle accident, workers’ compensation, Veterans Affairs, and out-of-state Medicaid.

At the core of our success is our highly valued team of over 1,400 teammates as reflected in one of our core guiding principles, “Our teammates are the foundation of our success.” United by a shared commitment to client excellence, we focus on achieving outstanding outcomes for our clients, aiming to consistently provide the highest revenue yield in the shortest possible time.

We are committed to creating a results-oriented work environment that is both challenging and rewarding, fostering flexibility, and encouraging personal and professional growth. Joining Aspirion means becoming a part of an industry leading team, where you will have the opportunity to engage with innovative technology, collaborate with a diverse and talented team, and contribute to the success of our hospital and health system partners. Aspirion maintains a strong partnership with Linden Capital Partners, serving as our trusted private equity sponsor.

We are seeking an Appeals Specialist to join our growing team. As an Appeals Specialist, you will be exposed to the complex reimbursement methodology between hospitals and insurance companies. Appeals Specialists work closely with assigned project teams on the specialized retrospective recovery process. You will be exposed to the revenue cycle process and various provider clients and systems.

Key Responsiblies

• Submit electronic and hard copy billing and conduct follow up with third party carriers for insurance claims.
• Investigate and coordinate insurance benefits for insurance claims across multiple service lines.
• Obtain claim status via the telephone, internet, and/or fax.
• Review and understand eligibility of benefits.
• Resolve accounts as quickly and accurately as possible, obtaining maximum reimbursement, and perform investigative and follow up activities in a fast-paced environment.
• Conduct research, contact patients, and the local affiliates to include VA, Hospitals, and insurance carriers.
• Handle incoming and outgoing mail, scanning, and indexing documents and handling any other tasks that are assigned.
• Research and verify insurance billing adjustment identification to ensure proper account resolution and act when necessary.
• Identify contractual and administrative adjustments.
• Work independently or as a member of a team to accomplish goals.
• Demonstrate excellent customer service, communication skills, creativity, patience, and flexibility.
• Follow established organization guidelines to perform job functions while staying abreast to changes in policies.
• Correspond with hospital contacts professionally using appropriate language while following the specific facility and department protocol.
• Uphold confidentiality regarding protected health information and adhere to HIPPA regulation.
• Interact with all levels of staff.
• Cross train in multiple areas and perform all other duties as assigned by management.

Requirements

• Active listening
• Ability to multi-task
• Exceptional phone etiquette
• Strong written and oral communication skills
• Effective documentation skills
• Strong organizational skills
• Service orientation
• Reading comprehension
• Critical thinking
• Social perceptiveness
• Time management and reliable attendance
• Fast learner

Education and Experience

• High School Diploma or equivalent
• Bachelor's degree preferred, or equivalent combination of education, training, and experience
• 2 or more years of experience of hospital billing, insurance follow-up, denials, or appeals preferred
• Remote work experience preferred

Benefits

At Aspirion we invest in our employees by offering unlimited opportunities for advancement, a full benefits package, including health, dental, vision and life insurance upon hire, matching 401k, competitive salaries, and incentive programs.

The US base pay range for this position starts at $19.00 hourly. Individual pay is determined by a number of factors including, but not limited to, job-related skills, experience, education, training, licensure or certifications obtained. Market, location and organizational factors are also considered. In addition to base salary, a competitive benefits package is offered. 

AAP/EEO Statement

Equal Opportunity Employer/Drug-Free Workplace: Aspirion is an Equal Employment Opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, age, sex, pregnancy, religion, national origin, ancestry, medical condition, marital status, gender identity citizenship status, veteran status, disability, or veteran status. Aspirion has a Drug-Free Workplace Policy in effect that is strictly adhered to.

Please note that this position is contingent upon the successful completion of a pre-employment drug screening and background check. These steps are part of our standard hiring process to ensure a safe and compliant workplace.