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Appeals Specialist

Universal Health Services

Job Code:
Universal Health Services
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Job Details

Appeals Specialist

Job Code:  242963
Facility: Pacific Region CBO
Location: MURRIETA, CA US Western
Region: Western
Travel Involved: None
Job Type: Full Time
Job Level:  Experienced (Non-Manager)
Minimum Education Required: High School or equivalent 
Category: Accounting/Finance,Professionals
FTE: 1.0
Position Summary:

Position Summary:

Universal Health Services, Inc. (UHS) is one of the nation's largest and most respected health care management companies, operating through its subsidiaries acute care hospitals, behavioral health facilities and ambulatory centers nationwide. Founded in 1978, UHS subsidiaries now have more than 65,000 employees. The UHS business strategy is to build or purchase health care properties in rapidly growing markets and create a strong franchise based on exceptional service and effective cost control. Our success comes from a responsive management style and a service philosophy based on integrity, competence and compassion


The Pacific Region CBO facility is located in Murrieta California. We are one of three Centralized Business Offices within UHS. Our CBO supports 6 UHS Hospitals. We have approximately 100 valued employees at our facility.


The Pacific Region CBO currently has a Appeals Specialist position available.  The candidate selected will be responsible for the following: 

The Appeals Specialist will be responsible for Managing the daily activities related to the CBO's Appeals function. The position will analyze trends and root cause issues in insurance denials and work with insurance companies to implement ways to resolve underlying reasons for denials. This position will work as a liaison between Clinical Appeals and other departments to conduct billing and charging compliance. This position will also provide clinical knowledge for CBO staff and consultation to management as needed.


The following are the job requirements for the Appeals Specialist Position:

This position must have excellent organizational and assertive communication skills to articulate knowledge both verbally and in writing, have an understanding of coding and billing principles and philosophies. Be proactive, assertive, and have the ability to prioritize and multi- task. Able to process denial and appeal types for collection effort for balance on account involving calling payers, writing appeals, and defending claim logic and medical record documentation. Must have the ability to be detail oriented. Must have the ability to work effectively with payers, case managers & utilization. Must have an understanding of various audit processes. Must be Customer focused, providing service consistently exceeding expectations to both internal and external customers. Proficiency in Microsoft Office applications (word and excel)  and others as required.

Experience in working with Patient Financial Service and an understanding of the Revenue Cycle from beginning to end is preferred.


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