Medical Billing Appeal Specialist

Job Summary

Supporting the Appeal team in a full-time remote capacity, the Revenue Cycle Medical Billing Commercial Appeal Specialist will manage denied and underpaid claims by classifying appeals, preparing necessary documentation, and following up with payors to ensure timely processing.

Key responsibilities

• Review Explanation of Benefits and denial letters to classify the type of appeal required
• Gather and prepare documentation needed to submit appeals according to payor guidelines
• Follow up with payors regarding the status of appeals and document all relevant details in billing software

Required qualifications

• Minimum of one (1) year of advanced medical billing experience
• Fluency in English with professional written and verbal communication skills
• Knowledge of insurance billing guidelines and experience with Commercial Insurance appeal processes
• Ability to work independently and as part of a team
• High School diploma or equivalent, or significant relevant work experience