• Analyzes information required to complete appeals with insurance carriers, service area contacts and workmans compensation carriers for all facilities within UVA Health System or Professional Medical Groups.

• Demonstrates skill in the proficient use of UVA software systems to ensure appeal and/or retro-authorization information is entered into required computer systems and to the payors in an accurate and timely manner.

• Demonstrates the skills of effective communication, decision-making and organization to ensure efficient job performance and job success.

• Demonstrates ability to adhere to policies and procedures.

• Demonstrates high proficiency in Epic including but not limited to payor contracts and expected reimbursement calculations.

• Must be able to sufficiently understand the fundamentals of payor contracts at multiple hospital locations simultaneously and utilize the contracts to support appeal and reconsideration arguments.

• Demonstrates the ability to identify different payor trends for multiple hospital locations concurrently.

• Ability to communicate effectively and professionally with multiple provider reps to resolve underpayment trends efficiently.

• Proficient working knowledge of payor remittances to easily identify basis of underpayment received including but not limited to remark codes, DRG, SOI, CPT, HCPCS, etc,

• High level analysis to identify payor down coding, readmission reductions or incorrect contracts to efficiently determine the underpayment reason and the appropriate steps to resolution.

• Must work with outside departments when necessary to resolve the underpayment including but not limited to Billing, Payor Audits and Internal Appeals RN for clinical support.

Benefits

• Comprehensive Benefits Package: Medical, Dental, and Vision Insurance

• Paid Time Off, Long-term and Short-term Disability, Retirement Savings

• Health Saving Plans, and Flexible Spending Accounts

• Certification and education support

• Generous Paid Time Off

UVA Health is a world-class Magnet Recognized academic medical center and health system with a level 1 trauma center. 2023-2024 U.S. News & World Report Best Hospitals guide rates UVA Health University Medical Center as High Performing in 5 adult specialties and 14 conditions/procedures. We are one of 70 National Cancer Institute designated cancer centers. UVA Health Childrens is named by 2023-2024 U.S. News & World Report as the best children's hospital in Virginia with 9 specialties ranked among the best in the nation. Our footprint also encompasses 3 community hospitals and an integrated network of primary and specialty care clinics throughout Charlottesville, Culpeper, Northern Virginia, and beyond.

The University of Virginia is an equal opportunity employer. All interested persons are encouraged to apply, including veterans and individuals with disabilities. Learn more about UVAs commitment to non-discrimination and equal opportunity employment.