Appeals Coordinator

Temple University Health System; United States; On-site; USD 65,000 - 90,000; Full time

Job summary

Temple Health is seeking an Appeals Coordinator to clinically assess adverse determinations by insurers through all levels of the appeals process. The role supports patient care continuity and requires a PA nursing license and familiarity with accreditation and coding guidelines.

Based in Philadelphia, PA, this full-time day-shift position focuses on operational administration within Temple Health's network.

Qualifications

• RN licensed in PA required
• Experience with InterQual/Milliman criteria
• Experience with ICD-10-CM coding
• APC coding knowledge preferred

Skills

InterQual/Milliman criteria

ICD-10 coding

APC coding

Education

Graduate of an accredited school of nursing

Job description

Appeals Coordinator – (263109)

Description

Responsible for clinically assessing all adverse determinations made by insurers through all levels of the appeals process.

Education

• Other Graduate of an accredited school of nursing Required

Experience

• General Experience and knowledge of InterQual and Milliman criteria. Required
• General Experience and working knowledge of ICD-10 CM coding Required
• General Experience and Knowledge of APC coding Preferred

Licenses

• PA Registered Nurse License Required
• Multi State Compact RN License Required Or

Temple Health is a dynamic network of outstanding hospitals, specialty centers, and physician practices that is advancing the fight against disease, pushing the boundaries of medical science, and educating future healthcare professionals. Temple Health consists of Temple University Hospital (TUH), Fox Chase Cancer Center, TUH-Jeanes Campus, TUH-Episcopal Campus, TUH-Northeastern Campus, Temple Physicians, Inc., and Temple Transport Team. Temple Health is proudly affiliated with the Lewis Katz School of Medicine at Temple University.

To support this mission, Temple Health is continuously recruiting top talent to join its diverse, 10,000 strong workforce that fosters a healthy, safe and productive environment for its patients, visitors, students and colleagues alike. At Temple Health, your tomorrow is here!

Equal Opportunity Employer/Veterans/Disabled

An Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

Your Tomorrow is Here!

Temple University Hospital is a nationally respected teaching hospital on Temple University’s bustling Health Sciences Center campus. The hospital provides a comprehensive array of healthcare services both basic and complex to patients from around the corner, across the country and around the world. As the chief clinical training site for the Lewis Katz School of Medicine at Temple University, the hospital provides a dynamic environment for high-quality care, teaching, and cutting edge research.

Primary Location

Pennsylvania-Philadelphia

Job

Operational Admin & Management

Schedule

Full-time

Shift

Day Job

Employee Status

Regular