Denials and Appeals Representative

Job Summary

To support the processing of denied claims, the full-time Denials and Appeals Representative will manage correspondence, follow up on denied claims, and ensure compliance with billing regulations while working remotely.

Key responsibilities

• Perform diligent follow-up and appeals processes to secure payment on outstanding claims
• Research and address denials, ensuring thorough and accurate task completion to minimize rework
• Maintain knowledge of billing forms and compliance requirements for various payer types

Required qualifications

• Approximately two+ years of experience with insurance denial and correspondence processes
• High school diploma or equivalent; some college coursework preferred
• Knowledge of health insurance correspondence denial processing and coordination of benefits
• Familiarity with physician billing guidelines for commercial and government payers
• Proficiency in Microsoft Excel, Outlook, and Word, with experience in billing systems preferred