Job Description

Appeal Specialist Would you like to join an organization that is experiencing rapid growth? You may be the person we are looking for! NextGen Business Solution looking for experienced Appeal Specialist. NGBS was founded with the goal of revolutionizing health care by providing exemplary services to our value-based service partners. Great work comes from people who are inspired to achieve their best. Our team is made up of talented and experienced individuals dedicated to improving healthcare quality. You will find ample opportunity for growth and innovation within NGBS\'s fast-growing company. PRINCIPAL ACCOUNTABILITIES The Appeals Specialist will manage the organization\'s third-party payer appeals through the ability to analyze, research, and successfully appeal third party claims within timely filing timelines. Ideal candidates will demonstrate expertise in all facets of the electronic billing appeals function for insurance defense matters which may include multiple payors, SIRs and other complex billing arrangements. Research and resolve invoice deductions. Consistently meet appeal deadlines Assist with supervisors in Aderant conversion. Assist with inquiries and special projects as needed. Assist Billing Submission Specialists as needed. Requires investigational and analytical skills. Coding skills highly preferred Ensures case closure correspondence is generated in accordance with regulatory and statutory requirements and in response to instructions from external review entities. Additionally, this position will collaborate with key stakeholders and assist in developing appeal strategies to include reference material for staff, letter templates, and regular feedback for revenue cycle coding staff; and functions as clinical subject matter expert related to coding denials and appeals. Acts as a liaison for issues affecting various teams (coding, revenue integrity, accounts receivable (AR) follow up, etc.) of the revenue cycle while also providing support when IT related or systematic changes are needed. Analyzes data from various sources (medical records, claims data, payer medical policies, etc.), determines the causes for denials of payment and partners with management to implement strategies to prevent future denials. Integrates the payer medical policies, case specific medical documentation, and claims information into a concise appeal letter, including appropriate medical records submission. Works assigned claim edit and follow up work queues and meets the assigned productivity standards on a daily basis as well as assigned patient account work queues and responds with resolutions within the expected time frame. Performs data mining and reporting activities that identify net positive impactful opportunities in denials and adjustments for the individual facilities and the system. Educate and train fresher on appeals. Other activities as assigned by the supervisor. MINIMUM QUALIFICATIONS Education: bachelor\xe2\x80\x99s degree

• Flexible working from 6pm \xe2\x80\x93 3am IST
• 2+ years\xe2\x80\x99 experience as appeal specialist
• 1+ year experience in cardiology appeal (Preferred)
• 1+ years\xe2\x80\x99 experience working in denial management and AR.
• Strong skills in CMS and insurance specific guidelines for billing
• Strong communication skills
• Advance skills in Microsoft excel.

Office Location: East Tambaram, Zip code: 600073 WORK FROM OFFICE Shift time: 6pm \xe2\x80\x93 3am IST Job Type: Full-time Pay: 920,000.00 - 930,000.00 per month Schedule:

• Monday to Friday
• Weekend availability

Supplemental pay types:

• Yearly bonus

Ability to commute/relocate:

• Chennai, Tamil Nadu: Reliably commute or planning to relocate before starting work (Preferred)

Experience:

• Medical Billing: 1 year (Preferred)
• Charge entry (Bill outs): 1 year (Preferred)
• Cardiology appeals: 1 year (Preferred)
• Cash posting: 1 year (Preferred)
• Accounts receivable (AR): 1 year (Preferred)
• Appeal specialist: 1 year (Required)
• Denial management: 1 year (Preferred)

Work Location: In person