Market Appeals Support Specialist

Market Appeals Support Specialist

Fort Lauderdale Behavioral Health is a 182-bed treatment facility that specializes in quality behavioral health and substance abuse services for youth, adults and seniors. We offer a full continuum of care through an integrated system of inpatient, residential, partial hospitalization and intensive outpatient programs. Progressive professionals in the fields of psychiatry, medicine, nursing, social services, education and activity therapy provide our comprehensive services.

The Market Appeals Support Specialist is responsible for managing and supporting the behavioral health appeals process, including following up with insurance companies, refiling denied or underpaid claims, and maintaining detailed records of appeal outcomes. The ideal candidate will have experience in healthcare claims and billing with a strong understanding of behavioral health services and payer requirements. Knowledge of CPT/ICS-10 coding and insurance billing guidelines. Familiarity with Medicaid, Medicare, and commercial payer requirements for behavioral Health. Effective written and verbal communication skills and proficiency in Microsoft Office. Strong organizational and documentation skills with excellent attention to detail. Experience working with electronic health records (HER) systems (Midas/Cerner/AS400). Knowledge of how to navigate the behavioral health revenue cycle.

Qualifications

High School Graduate/GED

3-5 years of experience

Specialized Skills/Knowledge

Knowledge of CPT/ICS-10 coding and insurance billing guidelines.

Familiarity with Medicaid, Medicare and commercial payer requirements for behavioral Health.

Effective written and verbal communication skills and proficiency in Microsoft Office.

Strong organizational and documentation skills with excellent attention to detail.

Experience working with electronic health records (HER) systems (Midas/Cerner/AS400). Knowledge of how to navigate the behavioral health revenue cycle.

Essential Job Duties

• Track and follow up on behavioral health appeals submitted to insurance companies, resolve claim and appeal issues effectively (15%)
• Refile denied or incorrectly processed claims in a timely and accurate manner (20%)
• Analyze Explanation of Benefits (EOBs), denial codes and remittance advice to determine appeal strategy. (10%)
• Maintain detailed and organized records of appeal submissions, follow-ups, outcome, and trends. (10%)
• Perform other duties as assigned/required by this position (5%)

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, placement, promotion and compensation of individuals without regard to race, color, religion, 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.