Appeals Support Representative - Remote

Overview

The Appeals Support Representative role directly supports the Clinical Appeals Specialist in the administrative functions of Denials and Appeals within the Utilization Review Team.

In Short

• This is a full-time remote position.
• Work hours are Monday through Friday, 8:00am-4:30pm EST or 8:30-5:00pm EST.
• Complete outbound calls to payers for status updates on retro authorization requests.
• Interact with third-party insurance representatives.
• Track and confirm weekly status updates on outstanding appeal cases.
• Request and organize payer correspondence regarding approvals and denials.
• Document final appeal outcomes and case details.
• Submit retro authorization requests and follow up until resolution.
• Attend monthly UR Team meetings and quarterly Denials meetings.
• Adhere to privacy and HIPAA guidelines.

Requirements

• Associate’s degree required or High School Diploma plus 5-7 years of relevant experience.
• Strong Microsoft Office skills (Excel, Word, Outlook).
• Experience with insurance follow-up and appeals required.
• Familiarity with medical billing and healthcare office experience.
• Excellent communication and customer service skills.
• Ability to work flexible hours.
• Strong attention to detail and organizational skills.
• Self-starter with the ability to multi-task.
• Ability to navigate Zoom and Microsoft Teams.
• Adaptability to changing situations.

Benefits

• 401(k).
• Healthcare benefits.
• Vacation and sick days.
• Employee referral program.
• Employee discounts to various stores and events.
• Continuing education programs and training.
• Weekly training opportunities.
• Advancement opportunities within the organization.