About the Role
The primary function of the Appeals Specialist is to support the Utilization Review (UR) Appeals process within the Department of Patient Accounts by providing follow-up and administrative assistance. This role involves entering, tracking, and analyzing appeal-related data, coordinating with external managed care organizations, physicians, and case managers, and assisting in the preparation of appeal documentation. The Appeals Specialist is also responsible for maintaining detailed logs and generating reports as needed.
What You’ll Do
Provides administrative support for the Utilization Review (UR) Appeals process within the Department of Patient Accounts
Performs follow-up on appeal cases to ensure timely and accurate resolution
Inputs, tracks, and analyzes appeal-related data for reporting and trending purposes
Collaborates with external managed care organizations, physicians, and case managers to facilitate the appeals process
Assists in preparing necessary documentation for appeals submissions
Maintains accurate and organized appeal logs
Generates reports as assigned to support department operations and compliance
What You’ll Bring
Preferred:
Bachelor’s degree in Business, Finance, Healthcare, or a related field required
Minimum of three (3) years of administrative support experience, preferably in a hospital or healthcare setting
Experience in report writing and data analysis required
Background in medical records, social work, finance, or utilization management preferred
Proficiency in developing and maintaining databases
Skilled in using various software applications
Proficient in Microsoft Word, Excel, and PowerPoint
Strong oral and written communication skills required
Excellent analytical and organizational abilities
Ability to work independently and collaboratively as part of a team
Equivalent related experience may be considered in place of the degree on a year-for-year basis
What We Offer
Compensation
The expected salary range for this position is PS/22S: $61,039.00 - $73,322.00 - $87,183.00 per year in accordance with the New Jersey Pay Transparency Law; final compensation will be commensurate with experience and qualifications.
About Us
University Hospital is one of the nation’s leading academic medical centers. As the principal teaching affiliate of Rutgers New Jersey Medical School and the only state-certified Level 1 Trauma Center in Northern New Jersey, University Hospital is training the next generation of physicians and advancing science to discovery while taking exceptional care of patients, regardless of their financial situation.
Apply Today
We encourage candidates from all backgrounds to apply. If you want to grow your career in healthcare while serving a vibrant community, we’d love to meet you.
University Hospital offers a competitive salary & comprehensive benefits package. Affirmative Action/Equal Opportunity Employer, M/F/D/V. For more information, visit www.uhnj.org/hrweb.
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