APPEALS SPECIALIST

UHS; Las Vegas (NV); On-site; USD 50,000 - 80,000; Full time

Benefits offered by this job

Challenging environment

Growth opportunities within UHS

Competitive compensation

Medical, dental, vision, RX plan

401k with company match

Job summary

Universal Health Services (UHS) - Western Region Consolidated Business Office (WCBO) is seeking a Billing/Appeals professional to manage denied claims and support medical necessity appeals in collaboration with Nurse Auditors.

The role emphasizes accuracy, timely follow-up, and clear communication with internal teams, leveraging hospital payer contracts to drive successful resolutions and maintain high quality service. Competitive compensation and full benefits are offered.

Qualifications

• Track the status of appeals, follow up regularly, and elevate issues as needed to facilitate timely resolution.
• Apply critical thinking and attention to detail in reviewing claims and related documentation.
• Utilize interpersonal skills to effectively communicate and collaborate with internal teams and external parties.
• Leverage experience with hospital acute care payer contracts to support claim resolution and appeals processes.

Responsibilities

• The role involves managing denied claims by identifying reasons for denial or dispute and collaborating closely with Nurse Auditors to support medical necessity appeals.

Skills

Interpersonal skills

Attention to detail

Critical thinking

Communication

Education

High school diploma or equivalent

Collections/Appeals experience

Job description

Responsibilities

Universal Health Services (UHS) - Western Region Consolidated Business Office (WCBO)

The Western Region Consolidated Business Office delivers comprehensive insurance revenue services to our affiliated UHS facilities, encompassing billing, collections, cash posting, pre-access management, variance analysis, and customer service. Our dedication to associate satisfaction and growth is recognized by industry leaders, exemplifying our commitment to fostering a positive and inclusive workplace culture. Our associates can count on competitive salaries, top-tier medical, dental, and retirement benefits, career training, and support for continued professional development.

Responsibilities

Universal Health Services (UHS) - Western Region Consolidated Business Office (WCBO)

The Western Region Consolidated Business Office delivers comprehensive insurance revenue services to our affiliated UHS facilities, encompassing billing, collections, cash posting, pre-access management, variance analysis, and customer service. Our dedication to associate satisfaction and growth is recognized by industry leaders, exemplifying our commitment to fostering a positive and inclusive workplace culture. Our associates can count on competitive salaries, top-tier medical, dental, and retirement benefits, career training, and support for continued professional development.

Job Description: 7:30AM-4:00PM

The role involves managing denied claims by identifying reasons for denial or dispute and collaborating closely with Nurse Auditors to support medical necessity appeals. This position requires preparing and submitting accurate appeal documentation, conducting thorough research to gather supporting evidence, and ensuring timely follow-up and resolution of appeals.

Experience

Qualifications

2 years healthcare/collection experience and/or equivalent experience in a hospital setting.

Education

Minimum of 2 years of previous Collections/Appeals experience. High school diploma or equivalent.

Requirements

• Track the status of appeals, follow up regularly, and elevate issues as needed to facilitate timely resolution.
• Apply critical thinking and attention to detail in reviewing claims and related documentation.
• Utilize interpersonal skills to effectively communicate and collaborate with internal teams and external parties.
• Leverage experience with hospital acute care payer contracts to support claim resolution and appeals processes.

This Opportunity Offers The Following

• Challenging and rewarding work environment
• Growth and Development Opportunities within UHS and its Subsidiaries
• Competitive Compensation
• Excellent Medical, Dental, Vision and Prescription Drug Plan
• 401k plan with company match

Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success.

Notice

At UHS and all our subsidiaries, our Human Resources departments and recruiter are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.