The Appeals Specialist is responsible for managing payer denials and working with payers to resolve reimbursement errors.
Responsibilities
Work with insurance companies to resubmit denied claims, over or underpaid claims, and claims that have processed inaccurately to secure payment on balances outstanding
Work with payers to understand specific reasons for denials and measures to prevent future denials
Navigate through and review patient medical records
Research payer requirements and utilize clinical knowledge to determine whether an appeal is required
Maintain confidentiality of patient data and medical records in compliance with HIPAA regulations
Utilize various communication tools including IM and video conferencing to enable virtual work collaboration
Qualifications
Bachelor's degree in any field (Undergrads are welcome to apply)
At least 2+ years of...
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