Appeals Representative

Job Summary

Appeals Representative is a full-time position responsible for reviewing assigned denials, preparing documentation for appeals, and ensuring claims are processed correctly and efficiently.

Key Responsibilities

• Review assigned denials to determine appropriate actions based on payer requirements
• Assemble and prepare required documentation for appeals in the billing system
• Maintain knowledge of carrier requirements for claim appeals and identify 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