Reimbursement Specialist (Claim Denial and Appeal Focus) - Remote

Overview

The Reimbursement Specialist will work remotely from their home office in the USA, focusing on resolving denied insurance claims for laboratory services and ensuring high levels of customer service.

In Short

• Responsible for resolving denied insurance claims.
• Provide additional documentation to payers.
• Initiate the appeal process on behalf of patients.
• Review Explanation of Benefits (EOBs) and denial letters.
• Assign appropriate ANSI codes and take action within the billing system.
• Communicate with insurance companies to obtain missing information.
• Interpret medical record documents and payer policies.
• Create custom appeals based on medical necessity criteria.
• Handle a high volume of claims work daily.
• Work Monday to Friday, 8:00 AM - 5:00 PM.

Requirements

• Two years of health insurance billing experience.
• Knowledge of payers' authorized representative forms.
• Experience with high-volume claims work.
• Typing speed of 35+ words per minute with high accuracy.
• Minimum one year in a healthcare reimbursement role.

Benefits

• Excellent annual salary plus 20% bonus potential.
• 20 accrued PTO days annually.
• 10 paid holidays.
• 401K with 100% company match up to 6%.
• 3 health care plan options with company HSA contribution.
• Company stock grant upon hire.