Denials and Appeals Representative

Job Summary

Working remotely in a full-time capacity, the Denials and Appeals Representative will process correspondence, follow up on denied claims, and ensure compliance with billing regulations while contributing to a cooperative team environment.

Key responsibilities:

• Perform diligent follow-up and appeals processes to secure payment on outstanding claims
• Research and address all denials with maximum collection efforts to ensure payment is received
• Maintain knowledge of billing forms and compliance with CPT, HCPCS, and ICD-10 coding regulations

Required qualifications:

• Approximately two years of experience with insurance denial processes in a multi-facility environment
• High school diploma or equivalent; some college coursework preferred
• Knowledge of health insurance correspondence and denial processing
• Understanding of physician billing guidelines for commercial and government payers
• Proficiency in Microsoft Excel, Outlook, and Word; experience with billing systems is desirable