Claims Denials Appeals Specialist

Job Summary

To support the Revenue Cycle Management team, the remote Claims Denials Appeals Specialist will manage the collection and denial management of assigned accounts, ensuring timely reimbursement from insurance companies for services rendered to patients.

Key responsibilities

• Perform collections to ensure receipt of medical claims within twenty-eight days
• Make outbound calls to insurance companies and utilize payer portals for claims resolution
• Prepare appeals for claim denials and document all correspondence with payers in the billing system

Required qualifications

• 2+ years of experience in collections, billing reimbursement, payer relations, or medical Accounts Receivable
• Experience with commercial medical insurance billing, Medicaid, and claims submission
• Proficiency in CPT, HCPCS, and ICD-10 Codes, as well as third-party billing and payer reimbursement patterns
• Familiarity with all-in-one practice management, clearinghouse, and billing software
• Knowledge of insurance guidelines including HMO/PPO, Medicare, and Medicaid