Denials and Appeals Representative

Job Summary

Working remotely in a full-time capacity, the Denials and Appeals Representative will manage the processing of correspondence related to denied claims, follow up on appeal statuses, and ensure compliance with billing regulations while collaborating within a team environment.

Key responsibilities

• Perform diligent follow-up and appeals processes to secure payment on denied claims
• Research and address denials with maximum collection efforts, ensuring compliance with relevant regulations
• Maintain productivity and quality standards while participating constructively within a team

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