MedData has an excellent career opportunity available as an
Appeals & Denials Claims Rep to work in our Draper, UT office. The
schedule for this full time role is Monday- Friday 7:30am -4pm.
**We are looking for individuals that have great customer
service skills, detailed, a knack for problem solving, a sense of
urgency and excellent communication skills.
The purpose of this position is to assist hospitals and
providers in resolving accounts that are denied and need
information from the patient who has been unresponsive to the
hospital/providers attempts to secure the needed information.
Specifically, this position is focused on the effort to obtain the
necessary forms, documents, responses from the patient, hospital,
employer and from other sources (including telephone, mail, email
and fax), resubmission of insurance bills and appeals to insurance
carriers. Unresponsive Patient Denial Claims Specialists facilitate
patients and insurances to ensure proper claim processing for
ESSENTIAL JOB FUNCTIONS:
+ Maintain a queue of Unresponsive Patient Denial accounts as
assigned by management
+ Maintain quality and productivity levels set by management,
once full job proficiency has been achieved.
+ Contact patient's employer, insurance carriers and patient via
telephone and mail to obtain required information for denied
+ Review and research insurance carriers to determine accurate
+ Ensure that patients properly update necessary information
according to payer and project specific guidelines
+ Investigate and work with patients to correctly update
necessary information and documentation with their insurance
+ Support patients by answering any questions about the
insurance process related to their account.
+ Coordinates with appropriate client personnel to ensure
appropriate filing guidelines are met for reimbursement.
+ Requests appropriate information, both verbally and written,
from appropriate parties to ensure proper claim disposition.
+ Perform manual data entry of patient accounts and/or claim
+ Resubmit hospital and physician bills to insurance companies
+ Maintain contact with insurance adjusters/carriers, employers
and patients during the claim adjudication process to ensure that
the hospital and physician bills are paid timely and in full.
+ Responsible for obtaining claim status and gathering
supporting documentation to submit appeals
+ Provide strong customer service to clients and provide
responses to client inquiries within 24 hours.
+ Provide detailed updates to MedData's account management
system and hospital/provider practice management system as account
work is completed.
+ Assist in training both new and existing employees, which may
include contributing specific training material.
+ Escalate complex, complicated or challenging accounts to
management to ensure accounts are progressing effectively.
+ Identify and discuss root cause issues with management.
+ Maintains and updates proper account documents in multiple
+ Assist management with adhoc inventory initiatives and other
projects, as needed
+ Makes written or verbal appeals to payers on denied
+ High School Diploma or GED, some college coursework
+ Ability to communicate effectively verbally and in writing and
be able to speak professionally with patients and insurance
+ Proven ability to be assertive in order to critical think and
proactively resolve issues
+ Demonstrate ability to organize and set priorities according
to situation all demands
+ Excellent customer service skills
+ Must have experience with data entry and word processing, be
capable of operating routine office equipment, possess a working
knowledge of MS Office applications, understand how to navigate
through web-based applications, and the ability to learn in-house
+ Positive team player attitude and mindset
+ 0-1 years of related experience in the field or in a related
MedData believes in making a positive impact not only within our
industry but also with our employees -the organization's greatest
asset. We take pride in offering comprehensive benefits in a vast
array of plans that contribute to the present and future well-being
of our employees and their families.
Just some of the benefits we offer:
+ Medical, Dental & Vision Insurance
+ HSA, FSA
+ Paid Time Off: Up to 3 weeks first year PTO plus 7 paid
+ Employee referral bonus program
+ Teamwork: We believe in teamwork and having fun together
+ Career Growth: Gain great experience to promote to higher
The physical demands described here are representative of those
that must be met by an employee to successfully perform the
essential functions of this job. Reasonable accommodations may be
made to enable individuals with disabilities to perform the
While performing the duties of this job, the employee is
frequently required to sit; use hands to finger, handle, or feel;
and reach with hands and arms. The employee is occasionally
required to stand and walk and must occasionally lift and/or move
up to 25 pounds.
The duties listed above are intended only as illustrations of
the various types of work that may be performed. The omission of
specific statements of duties does not exclude them from the
position if the work is similar, related, or a logical assignment
to the position.
This job description is to serve as a guide but no way is it to
be considered a comprehensive list of task, duties and
responsibilities that will be required by the employee.
To join our team of 2,000 employees and growing, please apply
directly to this posting.
MedData is an Equal Opportunity Employer
External Company URL: www.cardonoutreach.com
Street: 132 E 14075 S