FEATURED PROJECT: Medical Authorizations & Appeals Specialists $15.50 hourly
SALARY RANGE: $ 15.50 hourly
OPENINGS: Multiple 15
HOURS: Part time, and F/T hours 3 shifts
1st tier, nationwide health services providing healthcare and remote administrative support to nearly 3,000 providers. We are seeking a highly motivated Medical Authorizations & Appeals Specialist (Denial Specialist) to join our team.
The Medical Authorizations & Appeals Specialist (Denial Specialist) is primarily responsible for resolving all insurance claim denials for assigned specialty departments to enhance revenues for Medicine providers. The individuals in these positions will generate effective written appeals to carriers using well-researched logic in order to recoup reimbursement on incorrectly denied claims. Appeal carrier denials through coding review, contract review, medical record review and carrier interaction. Utilize a multitude of resources to ensure correct appeal processes are followed and completed in a timely manner. Demonstrate a high level of expertise in the management of complicated denied claims and deploy an analytical approach to resolving denials while recognizing trends and patterns in order to proactively resolve recurring issues. Communicate identified denial patterns to management. Prioritize and process a large volume of denials while maintaining high quality of work. Serve as an escalation point for unresolved denial issues. Inform team members of payer policy changes. Assist in training new employees as assigned. Collaborate on special projects as needed.
Ability to apply contract language in conjunction with a comprehensive understanding of claims denial appeal logic..
Drug and health screenings may be required for some positions. We are an equal opportunity employer.
DO NOT CALL, Resume Portfolio / VA Websites will be reviewed online and applicants will be contacted directly. Must have VOT resume profile and website available for review
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