Appeals Coordinator Resume
Every hospital or medical center aims at providing quality medical services at affordable rates to patients. However, it may happen that a patient or his family members may experience negligence on part of the doctors and administration in providing prompt and valuable medical care. Also, they may have certain doubts or queries regarding the medications used and the final billing amount levied on patients. This generates the need to appoint an appeals coordinator for the medical center. The appeals coordinator is responsible to investigate complaints and answer patient's requests satisfactorily. He needs to listen to the grievances intently and make note of the patient's problems and their expectations. He prepares an information report and investigates into the matter to find out the truth in the incident. Based on the investigations, he drafts a report to point out the facts and divert the case in favor of the medical center or the complaints as per the facts. In case the allegations are true, the appeals coordinator is expected to provide compensation to the patients or punish the guilty medical or administrative team members. The person may work for a hospital, medical care center, or independent social body.
We have drafted an appeals coordinator resume example. Make sure you present all facts and figures in your resume accurately. Highlight your career achievements and details of trends started in the organization to put a positive impression on the recruiter.
Appeals Coordinator Resume Example
Helen Mason
16, Jeremy Street
Columbus, OH 32214
Phone: 655 - 040 - xxxx
Email: helenmason@example.com
Career Objective:
To work as an appeals coordinator and provide satisfactory answers and feasible solutions to grieving patients and ensure quality medical care for them.
Summary of Skills:
- Comprehensive knowledge of medical terminology and health care customer service
- Familiarity with CPT/HCPC and ICD9 coding, guidelines and procedures
- Sincere, punctual, detail-oriented, and self-motivated individual
- Efficient at performing administrative and clerical functions
- Possess a sense of responsibility and high regards to ethical behavior
- Outstanding verbal and written communication
- Maturity to maintain confidentiality and healthy work relationships with patients and coworkers
- Ability to comply with Health Insurance Portability and Accountability Act (HIPSS)
Work Experience:
Appeals Coordinator
Columbus Redressal Forum, Columbus, OH
August 2013 - Present
- Make a note of the complaints registered against different hospitals within the city
- Evaluate eligibility of cases and admit suitable cases for evaluation
- Send compliant reports to hospitals and demand explanations for complaints registered
- Conduct investigations to check for negligence on part of medical teams
- Conduct meetings with both parties to find feasible solution for grievances
- Advise legal action against cases for medical negligence and billing mistakes
- Take suitable action against the offending members and provide compensation to grieving patients
Appeals Coordinator
Noble Hospital, Columbus, OH
May 2012 - July 2013
- Responded to complaints filed by patients and their family members and helped them understand the complexities
- Explained process of levying expenses and computation methods adopted to draft bills and justify final amount
- Made changes to figures in invoices in case of genuine overcharging or undercharging
- Reported cases of mistakes or negligence by medical staff to higher authorities
- Entered details of complaints and requests into computer systems and prepared documentation for further process
- Assured timely intervention and arbitration according to state and federal healthcare guidelines
Education:
-
Bachelor's Degree in Business Management
Columbus University, Columbus, OH
2011
Reference:
On request.
