Recognized for Excellence. Chosen for Caring.
Human Resources: 700 Lawn Avenue, Sellersville, PA 18960  |  215-453-4874
Audits and Appeals Coordinator
Full Time, 9am-5:30pm, Monday-Friday
Sellersville, PA 18960

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There's a new era of wellness ahead, and we no longer think about treating our bodies only when we're sick but nurturing our bodies when we are well, so we can stay in a perpetual state of good health. Grand View Health is leading the way to this new era with investments in technology, facilities, partnerships and, most importantly, compassionate and exceptional talent. Located in Upper Bucks County, Pennsylvania, Grand View Health is a well-established, independent hospital offering a full range of healthcare services. Our colleagues enjoy the best of both worlds by working for a high-quality, low-cost healthcare provider in a collaborative, community environment. Help us build this new era of wellness.
 

Responsibilities

Under the general direction of the Manager of Health Information Management, the Audit and Appeals Coordinator coordinates Recovery Audit Contracting activities to ensure that deadlines are adhered to. Responsible for hospital compliance with all federal, state and regulatory agencies to manage payer audits and appeals. Assumes the role of system administrator for the Audit and Appeals software product.

These duties will require the understanding of many complex and varying guidelines, systems, regulations and tools. The Audits and Appeals Coordinator will use critical thinking skills to manage an ever-evolving process that includes financial, clinical and legal components. The Audit and Appeals Coordinator will proactively work with GVH staff and physicians to put processes in place and to correct identified deficiencies that are impacted by retrospective denials.
 

Qualifications

EDUCATION AND EXPERIENCE:

  • Bachelor's degree and over 1 to 3 years of healthcare audit and appeals experience required.

 

SKILLS AND ABILITIES:

  • Demonstrated analytical skills required.
  • Demonstrated problem-solving skills required.
  • Demonstrated written communication skills required.
  • Strong verbal communication and listening skills required.
  • Effective interpersonal skills required.
  • Ability to maintain the strictest levels of confidentiality required.
  • Service-oriented required.
  • Self-directed required.
  • Possesses strong technical aptitude required.
  • Competency in the use of a variety of computer hardware and software systems required.

 

LICENSES AND CERTIFICATIONS:

  • RHIA or RHIT certification upon hire preferred.
  • Licensed Practical Nurse/Registered Nurse in PA – licensed, upon hire, preferred.
Grand View Health is an equal opportunity employer.
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