ABN and Appeals Coordinator (Remote in Wisconsin)

ABN and Appeals Coordinator |Atos Medical | New Berlin, WI

This position is remote but requires you to be easily commutable to our New Berlin, WI office for new-hire orientation and ongoing training as needed.

The ABN and Appeals Coordinator is responsible for executing the Advanced Beneficiary Notification requirements tailored to customer situations. Key responsibilities include analyzing and submitting claims appeals in accordance with health plan guidelines. This role involves managing all related appeal activities through to completion, utilizing all levels of appeals available while adhering to applicable regulatory guidelines to ensure compliance and optimal outcomes for customers.

Main job responsibilities:

• Generate the Advanced Beneficiary Notice as applicable and required when applicable.
• Review Advanced Beneficiary Notice for accuracy.
• Deliver Advanced Beneficiary Notice to customers for signature and return.
• Communicate the status and/or completion of the Advanced Beneficiary Notice to applicable internal parties.
• Attach all Advanced Beneficiary Notice to applicable customer account.
• Ensure the organization is utilizing the most current version of the Advanced Beneficiary Notices.
• Attend and communicate regulatory updates related to Advanced Beneficiary Notices.
• Review and process appeals within federal, state and health plan specific regulations.
• Collaborate with subject matter experts within the organization to obtain benefit and/or organizational opinions/interpretations of complex cases.
• Serve as liaison between members, health plan, and internal staff.
• Correspond with key individuals regarding appeal decisions and process.
• Act as subject matter expert regarding the grievances and appeals processes.

Basic Qualifications:

• HS Diploma or GED
• 2+ years of work experience with claims or appeals.
• Requires keen analytical thinking and excellent communication
• Basic knowledge of United States healthcare delivery system in payer setting or provider setting is required.

Preferred Qualifications:

• Advanced degree in a related field
• Knowledge of the Advanced Beneficiary Notification process
• 5 + years of background in customer service, Reimbursement or Appeals and Grievances in a health care related industry

Competencies:

• Must be collaborative and well-organized.
• Must possess good judgment and work effectively with internal business areas, peers and co-workers as well as external parties and customers.
• Must have strong computer skills, strong knowledge of Brightree and Microsoft office programs highly recommended.
• Ability to manage work independently end-to-end, meet milestones and provide deliverables on time.
• Ability to manage multiple tasks, prioritize them and pay attention to detail.
• Ability to recognize and direct information to the appropriate business partner.
• Ability to meet project milestones

We offer:

You will be part of an ambitious work environment in which teams work together to continuously grow and develop the business. You will have great opportunities to learn and develop, and you will be offered a competitive salary package and benefits.

Atos Medical is a global leader with Swedish headquarters and more than 20 subsidiaries worldwide. We are committed to living our values:we listen-we inspire-we focus-we engageevery day.Weconnect with stakeholders, involving them in our activities and striving to support and empower our users and each other every day. No matter whom we interact with - users, colleagues, health care professionals, business partners - respect and integrity are at the core of everything we do.

Additional benefits:

• Flexible work schedules with summer hours

• Market-aligned pay
• 401k dollar-for-dollar matching up to 6% with immediate vesting
• Comprehensive benefit plan offers
• Flexible Spending Account (FSA)
• Health Savings Account (HSA) with employer contributions
• Life Insurance, Short-term and Long-term Disability
• Paid Paternity Leave
• Employee Assistance Program
• Wellness Resources
• Training and Development
• Tuition Reimbursement

Atos Medical, Inc. is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. Equal Opportunity Employer Veterans/Disabled. To request reasonable accommodation to participate in the job application, please contact 800-217-0025.

Founded in 1986, Atos Medical is the global leader in laryngectomy care as well as a leading developer and manufacturer of tracheostomy products. We are passionate about making life easier for people living with a neck stoma, and we achieve this by providing personalized care and innovative solutions through our brands Provox, Provox Life and Tracoe.

We know that great customer experience involves more than first-rate product development, which is why clinical research and education of both professionals and patients are integral parts of our business.

Our roots are Swedish but today we are a global organization made up of about 1400 dedicated employees and our products are distributed to more than 90 countries. As we continue to grow, we remain committed to our purpose of improving the lives of people living with a neck stoma.

Since 2021, Atos Medical is the Voice and Respiratory Care division of Coloplast A/S

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