Morgan Stephens
Remote * (Spokane, WA, USA)
We are seeking and experienced Claims Appeals Specialist. Please note that remote positions require that you live within 25 miles of the job site - Spokane. PRINCIPAL DUTIES AND RESPONSIBILITIES: In accordance with State and Federal laws, identifies, investigates and resolves claims under review, returned, disputed, or denied by either a commercial or a government payer (e.g. Blue Cross Blue Shield or Medicare). Performs detailed review and analysis to investigate audit requests from Medicare Recovery Audit Contractors. Determines why a claim is under review, in dispute, or was denied. Coordinates with various internal departments ensuring all appropriate documentation is obtained in order to respond to audit requests appropriately. Ensures all requests for patient information meets applicable HIPAA requirements before information is shared. Requests copies of the medical records and corresponding claims. Analyzes information obtained to identify discrepancies and anomalies...