POSITION SUMMARY
The Medicare Appeals Specialist is responsible for appealing Medicare denials in a timely manner. The Medicare Appeals Specialist is also responsible for adjusting all appropriate claims, and entering secondary Medicare claim in Medicares direct data entry (DDE) system.

JOB QUALIFICATIONS
Education or Formal Training
Minimum high school diploma or equivalent preferred

Special Qualifications (Licensure, Registration, etc.)
CPAT certification preferred

Knowledge, Skill and Ability
1. Analytical abilities
2. Ability to communicate effectively
3. Basic math/accounting aptitude
4. Vision necessary to accurately process paperwork
5. Investigative and problem solving skills
6. High degree of flexibility in work assignments and goals
7. Manual dexterity to operate keyboards
8. Vision necessary to accurately process paperwork
9. Knowledge of word processing and data base applications
10. Ability to type 30 wpm
11. Ability to use ten-key adding machine
12. Able to work cooperatively with others under stressful situations and high volume periods and handle duties
13. with accuracy and organization
14. Must have neat and professional appearance
15. Excellent public relations skills required
16. Able to answer phones
17. Must exemplify hospital ENCORE! values and comply with house standards and values
18. Requires accuracy and attention to detail

Experience
1. Minimum two years experience in Government billing and collecting in a medical setting preferred
2. Experience in appeals or denial management

Materials and Equipment Directly Used
General office equipment, PCs and printers, PC-appropriate software for billing purposes, Operate phone system, Copy machine, Fax machine

WORKING ENVIRONMENT/PHYSICAL ACTIVITIES
1. Minimal lifting/bending to transport files
2. Long periods of sitting, data input, and phone usage