Appeals Coordinator I

Job Description

The appeals coordinator essentially works to coordinate the denials and appeals management process. Appeals coordinator is responsible for coordinating all audit correspondence, conducting oversight of all Authorization denials, RAC/audit functions, and following all RAC/audit activity and authorization appeals to closure. Appeals coordinator will help prepare medical records for Government/Commercial payer audits, timely filing of appeal correspondence, track and follow up of denials while working closely with the Corporate RAC team/ Facility Appeals coordinator, Business Office and Case Managers. The Appeals coordinator will also serve as the primary contact and coordinate the work to maintain integrity of tracking government review audits (RAC, MAC, CERT, ADR, Pre/Post Probes, QIO/Medicaid) and other payers as assigned.

The Appeals coordinator will further support the department needs for Release of Information, tracking and follow up or other duties as assigned.

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