Denied Claims and Appeals Specialist - Remote

Overview

The Denied Claims and Appeals Specialist is responsible for managing insurance denials by reviewing claims and clinical documentation, posting payments, handling correspondence letters and writing appeals to correct payment amount and/or non-payment.

In Short

• Fully remote position after training, Texas residents only.
• Reviews and appeals unpaid and denied claims.
• Attaches appropriate documents to appeal letters.
• Researches and evaluates insurance payments for accuracy.
• Logs appeals and grievances, tracking claims progress.
• Calls insurance companies regarding claims and payments.
• Manages Accounts Receivable reports for the Billing Department.
• Utilizes EMR system to submit and correct claims.
• Answers patient billing questions and handles collections.
• Maintains confidentiality and protects patient information.

Requirements

• High school diploma or GED required.
• Three or more years of related work experience.
• Excellent communication and customer service skills.
• Knowledge of medical terminology and coding.
• Ability to analyze electronic remittance advice.
• Strong organizational and problem-solving skills.
• Works well independently and in a team.
• Attention to detail and ability to prioritize tasks.
• Interpersonal skills for handling patient inquiries.
• Ability to maintain confidentiality of patient information.

Benefits

• Remote work flexibility after training.
• Opportunity to enhance practice reputation.
• Professional development opportunities.
• Supportive work environment.
• Regular and predictable attendance expected.