Appeals Analyst - Remote

Overview

The Appeals Analyst is responsible for monitoring contractual allowances, analyzing appeal opportunities with payers and networks, and reporting on appeals performance.

In Short

• Implement processes for identifying under-allowed claims.
• Review and analyze EOBs for under-allowed claims.
• Verify applicable contracts and member information.
• Refine communication skills for written and telephone appeals.
• Batch appeals by payer or network.
• Compile and submit appeals, monitoring reimbursement.
• Use Contract Manager application to track appeals.
• Work with managed care claims and appeals.
• Utilize advanced PC skills and Microsoft Office.
• Knowledge of medical terminology and managed care contracts.

Requirements

• Bachelor's degree in a related field or equivalent experience.
• Minimum of two years experience with managed care claims.
• Experience with Contract Manager application is a plus.
• Comfort in a production environment is essential.
• Experience with digital & remote office equipment.

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.