Manager of Appeals vacancy at ZOLL Medical Corporation in Pittsburgh

ZOLL Medical Corporation is at present looking to employ Manager of Appeals on Wed, 08 May 2013 08:02:35 GMT. Manager of Appeals: Essential Duties and Responsibilities include manages a staff of Appeals Coordinators and ensures that the responsibilities of each are completed in a timely and accurate manner. Other duties may be assigned. Timely filing of appeals to insurance companies Assist in preparing physicians for peer review and writing draft letters of medical necessity for prescribing physician...

Manager of Appeals

Location: Pittsburgh Pennsylvania

Description: ZOLL Medical Corporation is at present looking to employ Manager of Appeals right now, this vacancy will be placed in Pennsylvania. For detail informations about this vacancy opportunity please read the description below. Manager of Appeals:
Essential Duties and Responsibilities include manages a staff of Appeals Coordinators and ensures that the responsibilities of each are complet! ed in a timely and accurate manner. Other duties may be assigned.

Timely filing of appeals to insurance companies

Assist in preparing physicians for peer review and writing draft letters of medical necessity for prescribing physician

Responsible for designing and recommending improved processes or operational policies and works with Senior Management and peers to refine and implement those changes.

Develop and implement corrective action plans resulting from appeal outcomes

Responsible for tracking all cases in appeal for performance measurement and outcomes purposes along with keeping intake, Reimbursement Strategy and senior staff apprised of payer success stories and coaching them how to overcome payer objections to coverage.

Responsible for designing and recommending improved processes or operational policies and works with Senior Management and peers to refine and implement those changes.

Measures, tracks, ! and reports performance against standards

Supervisory! Responsibilities

This job has supervisory responsibilities.

Competencies

To perform the job successfully, an individual should demonstrate the following competencies:

Analytical - Collects and researches data.

Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Works well in group problem solving situations.

Interpersonal Skills - Maintains confidentiality.

Oral Communication - Speaks clearly and persuasively in positive or negative situations.

Written Communication - Writes clearly and informatively.

Teamwork - Contributes to building a positive team spirit.

Judgment - Exhibits sound and accurate judgment.

Planning/Organizing - Prioritizes and plans work activities; Uses time efficiently.

Professionalism - Reacts well under pressure.

Quality - Demonstrates accuracy and thoroughness.

Qu! alifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Required Skills

Excellent clinical skills related to cardiac disease case management.

Persuasive negotiation and time management skills along with a strong knowledge of all payer types, to include Medicare, Medicaid, and third party commercial insurance companies.

Superior communication and customer service skills.

Proficiency in MS Office Suite .

Language Skills

Ability to read, analyze, and interpret common scientific and technical journals, financial reports, and legal documents. Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of! the business community. Ability to effectively present information to ! top management.

Mathematical Skills

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

Reasoning Ability

Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.

Computer Skills

To perform this job successfully, an individual should have knowledge of Internet Explorer and Proficiency in MS Office Suite.

Certificates, Licenses, Registrations

Registered Nurse Designation

Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommoda! tions may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to sit and use hands to finger, handle, or feel. The employee is frequently required to talk or hear. The employee is occasionally required to walk. The employee must occasionally lift and/or move up to 10 pounds.

Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually quiet.

Required Experience

Education and/or Experience

Bachelor’s degree in nursing with a Registered Nurse designation preferred but not required.

5-7 years experience as a hospital or payer-based case manage! r, discharge planner, or medical insurance claims processing.

! Leadership/Management Experience
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If you were eligible to this vacancy, please email us your resume, with salary requirements and a resume to ZOLL Medical Corporation.

If you interested on this vacancy just click on the Apply button, you will be redirected to the official website

This vacancy starts available on: Wed, 08 May 2013 08:02:35 GMT

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