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 amounts and/or non-payment.

In Short

• Fully remote position after training, available only for Texas residents.
• Reviews and appeals unpaid and denied claims.
• Researches and evaluates insurance payments for accuracy.
• Logs appeals and tracks the progress of claims.
• Communicates with insurance companies regarding claims.
• Manages Accounts Receivable reports.
• Utilizes EMR systems for claims submission and correction.
• Handles patient billing inquiries and complaints.
• Operates standard office equipment.
• Adheres to professional standards and policies.

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.
• Maintains confidentiality of patient information.
• Competence in managing multiple tasks effectively.
• Strong written and verbal communication skills.

Benefits

• Opportunity to work remotely after training.
• Engagement in a supportive work environment.
• Professional development opportunities.
• Access to medical office resources.
• Potential for career advancement within the organization.