Reimbursement Specialist - Appeals

Job Summary

A company is looking for a Reimbursement Specialist - Appeals to support post-submission reimbursement activities.

Key Responsibilities

• Manage various denial types and prepare appeals for submission
• Investigate denials and follow up with payers to ensure accurate reimbursement
• Maintain documentation of denials, appeals actions, and payer communications

Required Qualifications

• 4+ years of experience in reimbursement or denials management within a diagnostics or payer environment
• Bachelor's degree or equivalent experience
• Experience with Xifin, Quadax, or Telcor preferred
• Strong understanding of medical benefit structures and coding guidelines
• Proven ability to analyze denials and resolve issues effectively