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Human Resources: 700 Lawn Avenue, Sellersville, PA 18960  |  215-453-4874
Appeals Coordinator - Case Management
Full Time, 7:30am-4pm, Monday-Friday
Sellersville, PA 18960
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Under the general direction of the Manager of Case Management, the Appeals Coordinator manages the third-party appeal process. The Appeals Coordinator is responsible for maintaining and updating correspondences and receipt acknowledgments within files and database.

Essential Functions:
  • Processes third-party denials/appeals upon notification of an insurance denial, either by the Case Manager or the insurance company.
  • Manages third-party appeals and denials in the Case Management and MEDITECH databases in order to provide accurate reporting at various hospital committees.
  • Completes data entry for all Denial and Appeal Management processes.
  • Maintains all correspondences and receipt acknowledgments to ensure receipt by payors.
  • Coordinates the telephonic and written appeal processes with Case Management staff, physician advisors and payors.
  • Manages the Retro Appeal process for the department (RAC, MAC, QIC, commerical payors, etc.).
  • Assists in the build and maintenance of department databases as needed.
  • Prepares and analyzes reports using Excel and department software for department and committee reporting.
  • Works with Business Office to investigate and resolve outstanding utilization review/reimbursement issues.
  • Participates as a team member in establishing procedures relating to Case Management functions to promote efficient operations.
  • Demonstrates ability to prioritize work assignments in order to meet deadlines and maintain timely department operations.
  • Performs Case Management Technician's functions in her absence to ensure continuity in Case Management department.
  • Communicates denial trends to Case Management leadership.


  • High school diploma/GED and 1-3 years of business experience in healthcare billing. Prefer knowledge of billing, case management coding, precertification, contracts, financial account reconciliation and insurance payor regulations (commercial and government).

  • Medical, free dental, vision insurance for full time and part time
  • 403B
  • Pension plan
  • On-site discounted child care center
  • Tuition reimbursement up to $5250 per year
  • Free life insurance
  • Free parking
  • Paid time off
  • Sick time
  • Flexible spending accounts
  • Employee referral bonus
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