Medical Billing Appeal Specialist

Job Summary

Supporting the Appeal team in a full-time capacity, the Revenue Cycle Medical Billing Commercial Appeal Specialist will manage the review of denied and underpaid claims, prepare necessary documentation for appeals, and engage with patients to gather required information, all while working remotely.

Key responsibilities

• Classify types of appeals by reviewing Explanation of Benefits, denial letters, and payor correspondence
• Prepare and review documentation needed to submit appeals according to payor guidelines
• Follow up with payors on the status of appeals and identify potential improvements in the appeal process

Required qualifications

• Fluency in English
• Minimum of one year of advanced medical billing experience
• Knowledge of insurance billing guidelines and policies
• High school diploma or equivalent or significant relevant work experience
• Experience with commercial insurance appeal and reconsideration processes preferred