Appeals Processing Analyst (Payment Analysis) - Remote - Nationwide

Remote, Nationwide Seeking Appeals Processing Analyst

Everybody Has A Role To Play In Transforming Healthcare

If you want to be part of changing healthcare to better serve patients, you are in the right place. With Vituity you will join a team of individuals dedicated to our culture of caring and work to develop and implement innovative solutions, while tackling some of the healthcare industry’s most challenging situations from the inside.

Join the Vituity Team. At Vituity, our core values matter. We embody a Culture of Caring by approaching every human interaction with compassion and heart.

With a Servant Leadership philosophy, we focus on what we can accomplish when we put our patients and colleagues first. An Ownership Mentality means we all have mutual accountability to drive positive change for Vituity as a whole.

Finally, our focus on Innovation enables all of us to re-imagine healthcare and bring about lasting change. Ultimately, we are unified around the common purpose of transforming healthcare to improve lives, and we believe everyone has a role to play in that.

Help us shape the future of healthcare.

Vituity Locations : Vituity has opportunities at 450 practice locations across the country, serving 8 million patients a year.

With Vituity, if you ever need to move, you can take your job with you.

The Opportunity

• Analyze and process accounts following compliance guidelines.
• Process payer correspondence request.
• Verify patient account to ensure the accuracy of Financial Class, CID and INSKY.
• Utilize internal and external applications and websites.
• Verify explanation of benefits (EOB) have been posted correctly in the patient account.
• Verify no exceptions exist and site matrix is applicable.
• Validate claim to ensure correct provider was assigned.
• Research provider status and eligibility on external websites.
• Obtain payer fee schedule from external website.
• Identify contract matrix discrepancies and / or gaps and communicate accordingly.
• Process and / or apply activity code or PDR to account as applicable.
• Verify documents, Email, mail or fax details to internal or external resources.
• Collaborate with internal departments to resolve account discrepancy.
• Update patient account to bill out insurance or balance to patient if applicable.
• Contact the patient or insurance company on an account.
• Identify trends and communicate to leadership team.
• Other tasks as assigned by Supervisor or Manager.

Required Experience and Competencies

• High School Diploma or GED required.
• 2+ years working experience at Vituity RCM required.
• CPU / AS400 or another billing system experience preferred.
• Prior phone proficiency preferred.
• Basic understanding of all department tasks preferred.
• High level knowledge of RCM Operations preferred.
• ICD 10 coding and CPT understanding preferred.
• Possess strong interpersonal skills to work within a team environment.
• Possess strong verbal and written communication skills.
• Effective customer service skills with internal and external customers.
• Ability to read and comprehend simple instructions, short correspondence, and memos.
• Effectively present information in one-on-one or small group situations to customers, clients, or other employees.
• Ability to correctly add, subtract, multiply and calculate percentages.
• Ability to follow department and compliance guidelines.
• Ability to work in a fast-paced environment.
• Flexible and adaptable to an ever-changing environment.
• Ability to make phone calls seeking account resolution.
• Identify trends and communicate to manager or leadership team.
• Experience handling debits and credits (reconciliation processes).
• Effectively balance payer EOB’s and / or allocate patient payments.
• Ability to reconcile payer correspondence.
• Perform 10-key by touch.
• Ability to work proficiently within Microsoft Office; Word, Excel, Outlook.
• Works collaboratively with another department or region.
• Other tasks as assigned by Supervisor or Manager.
• Ability to work overtime during peak periods.

The Community

Even when you are working remotely, you are an important part of the Vituity Community. We offer plenty of opportunities to engage with other Vitans through a variety of virtual meet-and-greets, events and seminars.

• Monthly wellness events and programs such as yoga, HIIT classes, and more.
• Trainings to help support and advance your professional growth.
• Team building activities such as happy hours and holiday celebrations.
• Flexible work hours.
• Opportunities to attend Diversity, Equity and Inclusion (DEI) events including LGBTQ+ History, Día de los Muertos Celebration, Money Management / Money Relationship, and more.

Benefits & Beyond*

Vituity cares about the whole you. With our comprehensive benefits package, we are mindful of what matters most, and support your needs of today and your plans for the future.

• Superior health plan options.
• Dental, Vision, HSA / FSA, Life and AD&D coverage, and more.
• Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6%.
• Outstanding Paid Time Off : Four weeks’ vacation, Paid holidays, Sabbatical.
• Student Loan Repayment Program.
• Professional and Career Development Program.
• EAP, travel assistance and identify theft included.
• Wellness program.
• Diversity, Equity and Inclusion (DEI) initiatives including LGBTQ+ History, Día de los Muertos Celebration, Money Management / Money Relationship, and more.
• Purpose-driven culture focused on improving the lives of our patients, communities, and employees.

The Salary range for this role is $17.47 - $21.40 per hour. Please speak with the recruiter for more information.

We are unified around the common purpose of transforming healthcare to improve lives and we believe everyone has a role to play in that.

We know that when we work together across sites and specialties as an integrated healthcare team, we can exceed the expectations of our patients and the hospitals and clinics we work in.

If you are looking to make a difference, from clinical to corporate, Vituity is the place to do it. Come grow with us.

Vituity appreciates differences; our dedication to diversity, equity and inclusion is at the heart of our organization. Vituity does not discriminate against any person on the basis of race, creed, color, religion, gender, sexual orientation, gender identity / expression, national origin, disability, age, genetic information (including family medical history), veteran status, marital status, pregnancy or related condition, or any other basis protected by law.

Vituity is committed to complying with all applicable national, state and local laws pertaining to nondiscrimination and equal opportunity.

Benefits for part-time and per diem vary. Please speak to a recruiter for more information.

Applicants only. No agencies please.