Location: US:PA: Hershey
Work Type: Full Time
FTE: 1.00
Shift: Day
Hours: 8:00a - 4:00p
Recruiter Contact: Garrett C. Kieffer at
[email protected]SUMMARY OF POSITION:Responsible for overseeing and optimizing the the appeals process and managing responses to third-party audits, including payer audits from Medicare, Medicaid, and commercial insurers. This role focuses on managing the overall inpatient appeal strategy of Penn State Health as well as managing the strategy around third-party audit response. In addition to responsibility to response to payers as it relates to appeals and audits, this role is also responsible for working with teams across the health system to identify and implement corrective actions to reduce audit denials and inpatient denials, with a goal of improving reimbursement, reduce follow-up work needed by PFS staff, and enhance the overall efficiency and effectiveness of the appeals process. This position manages the External Payer Audits and Appeals team and engages in the performance management of staff.
MINIMUM QUALIFICATION(S):- Bachelor's Degree or equivalent experience (4 years)
- Nine (9) years job related experience required.
Penn State Health offers an exceptional benefits package including medical, dental and vision with no waiting period as well as a Total Rewards Program that highlights a few of the many additional offerings below:- Be Well with Employee Wellness Programs, and Fitness Discounts (University Fitness Center, Peloton).
- Be Balanced with Generous Paid Time Off, Personal Time, and Paid Parental Leave.
- Be Secured with Retirement, Extended Illness Bank, Life Insurance, and Identity Theft Protection.
- Be Rewarded with Competitive Pay, Tuition Reimbursement, and PAWS UP employee recognition program.
- Be Supported by the HR Solution Center, Learning and Organizational Development and Virtual Benefits Orientation, Employee Exclusive Concierge Service for scheduling.
Union: Non Bargained
