Appeal Coordinator

Appeals Coordinator

PayerWatch, Inc. is a nationwide trusted leader in Healthcare revenue recovery. We use a twofold
approach to equip hospitals and health systems to achieve better outcomes at a lower cost. Our
Veracity Software and AppealMasters service help prevent and lower denials and reduce the cost of the
claims appeals process.

Job Title: Appeal Coordinator

Reports to: Senior Director of Clinical Appeal Services

Job Type: Full Time, Non-Exempt

Job Description:

The Appeal Coordinator is responsible for reviewing incoming communications and documentation,
identifying case specificity, and following each dispute to completion as defined by the client and payer
dispute process. The Appeal Coordinator will conduct all pertinent tasks in order to evaluate, respond,
and close accurately and timely, and in accordance with all established guidelines. To perform this job
successfully, the Appeal Coordinator must be able to complete tasks appropriately and timely, critically
analyze and interpret payer and provider communications and act accordingly.

Duties and Responsibilities

  • Processing medical reimbursements for denied commercial, government, and managed care
    claims as assigned.
  • Obtain and process documentation retrieval including medical records, EOBs, denial
    communications, and adding to case materials.
  • Analyzing and interpreting key information from EOB’s, audit and denial letters, and other
    dispute documentation and utilizing the information to take appropriate action to dispute
    payments and various denial scenarios.
  • Input all case information into the database and complete assigned tasks per departmental
    policies to ensure processing and timely delivery of appealed cases or appropriate feedback to
  • Contact payers/providers utilizing whatever means necessary to ensure cases are reviewed and
    outcomes provided in order to follow up on cases and move through the dispute process timely.
    This can include obtaining documents via portals, facsimiles, and telephone outreach.
  • Demonstrate organizational and time management skills to manage accounts.
  • Maintain a high level of integrity following all HIPAA rules and regulations to ensure patient
    confidentiality in all forms of communication and access only information on a need-to-know
  • Ability to work in a team environment by collaborating with others and sharing
    tools, skills, and knowledge.
  • Deliver superior front-line customer service.

Working Conditions

The Appeal Coordinator works in our corporate office.

QUALIFICATIONS Required Education and Experience

    • Associate degree or higher preferred
    • 1-2 years of related experience in a healthcare billing office, hospital office setting, or health
      insurance organizations
    • Proficient in Microsoft Office applications
    • Experience with web-based applications
    • Understanding of medical terminology
    • Attention to detail and critical thinking skills
    • Excellent written and verbal communication skills (including proper grammar, punctuation, and
      sentence structure)
    • Excellent prioritization and organizational skills; effectively manage competing priorities and
      multiple deadlines

    PayerWatch, Inc. provides equal employment opportunities to all employees and applicants for
    employment with regard to race, color, religion, gender, sexual orientation, national origin, age
    disability, genetic information, marital status, amnesty, or status as a covered veteran under applicable
    federal, state, and local laws.

    Please email all cover letters and current resumes to the attention of Gail Adams, Human Resources
    Director; gadams AT

    All qualified applicants will receive consideration for employment, transfer or promotion without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity, disability, or veteran status.