Appeals Representative

Job Summary

A company is looking for an Appeals Representative responsible for reviewing claims denials and preparing necessary documentation for appeals.

Key Responsibilities

• Reviews assigned denials to determine appropriate actions based on payer requirements
• Assembles and prepares required documentation for appeals in the billing system
• Maintains knowledge of carrier requirements for claim appeals and identifies consistent errors impacting claims processing

Required Qualifications

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