Appeals Representative

Job Summary

Reviewing assigned denials, the full-time Appeals Representative will ensure claims are processed correctly and efficiently while working remotely.

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 with strong organizational skills