Appeals Representative

Job Summary

A company is looking for an Appeals Representative responsible for reviewing claims denials and processing appeals.

Key Responsibilities

• Review assigned denials to determine appropriate actions based on payer requirements
• Assemble and prepare required documentation for appeal in the billing system
• Maintain knowledge of carrier requirements for claim appeals and report consistent errors impacting claims processing

Required Qualifications

• High school diploma or equivalent required
• Two years of previous medical billing experience preferred
• Knowledge of healthcare reimbursement guidelines, ICD-10, and CPT-4 coding preferred
• Proficient in Microsoft Office
• Self-motivated and well-organized