Appeals Representative

Job Summary

Driving impactful resolutions in patient care, the full-time remote Appeals Representative will review and resolve insurance claim denials, conduct research, and process appeals across various payers to ensure healthcare providers are compensated accurately.

Key Responsibilities

• Review, prioritize, and process assigned payment denials within established timelines
• Research claim issues using carrier websites and internal resources, and prepare appeal documentation for disputed claims
• Monitor payer updates and communicate new procedures that may impact claims processing

Required Qualifications

• High school diploma or equivalent required
• Medical billing experience preferred, with a focus on denial research and appeals processing
• Knowledge of physician billing policies and procedures across multiple states
• Experience with GE Centricity Business and Enterprise Task Manager (ETM) preferred
• Ability to work independently and adapt to changing priorities