Insurance Appeals Specialist

Job Summary

Working remotely, the full-time Insurance Appeals Specialist will manage insurance claim appeals for molecular and genetic testing services, preparing and submitting appeal documentation while collaborating with internal teams to resolve claim denials efficiently.

Key Responsibilities

• Review denied claims and develop appropriate appeal strategies based on payer guidelines
• Track appeal status and maintain accurate records in the billing system, following up with insurance companies as needed
• Stay updated on payer policies and ensure compliance with HIPAA and regulatory standards during appeal activities

Required Qualifications

• High school diploma required
• 2 years of experience in insurance appeals, medical billing, or revenue cycle operations
• Strong understanding of insurance processes and denial management
• Proficiency in billing systems and Microsoft Office Suite
• Detail-oriented with the ability to manage multiple priorities independently