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Appeals Processing Lead Analyst

  • Location

    Nashville, United States

  • Sector:

    Other Area(s)

  • Job type:

    Contract

  • Contact:

    Leric Arcigal

  • Job ref:

    19602

  • Published:

    over 1 year ago

  • Expiry date:

    2020-04-24

WAH or onsite at Nashville office

Support Supervisor and Team Leads with identifying root cause of misrouted documents and development of process improvements Inform leadership of any risk to any cases that are in FileBound Support Supervisor and Team Leads with identifying root cause of misrouted documents and development of process improvements Update Supervisor and Team Lead on any risks, issues or concerns identified with a case Track all cases currently in production Conduct live reviews of cases to ensure the appeal is being worked accurately Support Staff with addressing Process and Compliance questions related to the correct handling of an appeal Support staff questions as it relates to the correct identification and routing of an appeal request Support Tracking of Production/Quality of production staff Submit Production/Quality updates to Supervisor Share recent Quality findings Assist with training of new staff or updates as needed for current staff Submit requests in SharePoint when Training is needed for new staff or updates for current staff Submit requests in SharePoint for Job Aid updates as needed Support the Team Lead with the Review of all internal audit findings and provide rebuttals to Quality Review all Overturn/Uphold/Dismissal recommendations prior to the final decisions Support the sharing and application of lessons learned from IRE decision Assist with training of new staff or updates as needed for current staff Attend and participate in all Team calls Detailed understanding of CMS Part C Appeals Requirements