Appeals Analyst - Remote

Overview

The Appeals Analyst is responsible for monitoring contractual allowances, analyzing appeal opportunities with payers and networks, and reporting appeals performance, all while operating in a remote environment.

In Short

• Monitor and analyze under-allowed claims.
• Review and analyze Explanation of Benefits (EOBs).
• Verify applicable contracts and member information.
• Prepare written and telephone appeals.
• Batch appeals by payer or network.
• Submit appeals and monitor reimbursement.
• Track appeals using Contract Manager application.
• Maintain confidentiality of medical records.
• Participate in professional development for managed care reimbursement trends.
• Work in a home-based role.

Requirements

• Bachelor's degree in a related field or equivalent experience.
• Minimum of two years experience with managed care claims and appeals.
• Experience with Contract Manager application is a plus.
• Proficiency in Microsoft Office products.
• Knowledge of healthcare professional services billing and reimbursement.
• Familiarity with medical terminology and managed care contracts.

Benefits

• Medical, life and dental insurance.
• Flex Work/Work from home options.
• Paid time off and annual performance bonus.
• Education reimbursement and family bonding leave.
• Referral program and more.