Appeals Analyst

Heredia, Heredia Province, Costa Rica

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

Data and Technology, Financial Services, Healthcare, Automotive, Agribusiness, InsuranceIndustries

Requirements

Candidates should possess a Bachelor's degree in a related field, or equivalent education and experience. A minimum of two years of experience working with managed care claims and appeals for health care professional services is required. Advanced PC skills, proficiency in Microsoft Office Suite, and knowledge of the healthcare professional services billing and reimbursement environment are essential. Familiarity with medical terminology, various network types, and managed care principles is also necessary.

Responsibilities

The Appeals Analyst will monitor contractual allowances, analyze and pursue appeal opportunities with payers and networks, and report on appeals performance. This role involves identifying under-allowed claims, reviewing and analyzing Explanation of Benefits (EOBs), and verifying applicable contracts. The analyst will refine communication skills for preparing appeals, batch appeals by payer or network, and monitor for proper reimbursement. Responsibilities also include tracking appeals and outcomes using the Contract Manager application, establishing contacts within payer offices, monitoring and providing feedback on errors, and participating in meetings to discuss trends. Maintaining confidentiality of medical records and engaging in professional development to stay current with managed care reimbursement trends are also key duties.

Skills

Appeals analysis

Contract analysis

EOB review

Managed care plans

CPT/HCPCS coding

Communication skills

Data analysis

Reporting

Expedia

Travel booking platform for flights, hotels, rentals

About Expedia

Expedia Group operates in the travel industry, offering a wide range of services for travelers and travel-related businesses. It connects users with options for flights, hotels, car rentals, vacation packages, and activities through its various brands, including Expedia, Hotels.com, and Vrbo. Travelers can easily find and book trips that match their preferences and budgets. The company earns revenue primarily through commissions on bookings and advertising from travel service providers looking to promote their offerings. Additionally, Expedia Group supports its partners by providing access to valuable data and technology, helping them improve their operations and grow their businesses. The goal of Expedia Group is to create a seamless travel experience for users while maximizing the potential of its partners.

Bellevue, WashingtonHeadquarters

1996Year Founded

$3,277.3MTotal Funding

IPOCompany Stage

Consumer Goods, EntertainmentIndustries

10,001+Employees

Benefits

Competitive Paid Time Off

Travel Discounts

Healthcare Flexible Spending Accounts

Employee Assistance Program

Wellness & Travel Reimbursement

Workplace Accomodations

Medical, Dental, & Vision Insurance

Matching Gifts

New Parental Benefits

Risks

Riyadh Air's entry could increase competition, affecting Expedia's market share.

CFO transition may lead to strategic shifts impacting financial management and investor confidence.

Expedia's partnerships may strain resources, affecting service quality if not managed well.

Differentiation

Expedia offers a comprehensive suite of travel services under one platform.

The company leverages a diverse portfolio of brands like Hotels.com and Vrbo.

Expedia provides partners with valuable data and technology to optimize their offerings.

Upsides

Expedia can capitalize on the rise of 'workcations' with longer stay packages.

The trend of 'bleisure' travel offers opportunities for specialized leisure-business packages.

Increased demand for personalized travel experiences can enhance user engagement for Expedia.

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