Revenue Cycle Medical Billing Commercial Appeal Specialist

Revenue Cycle Medical Billing – Commercial Appeal Specialist

Location:

Remote or On-Site, United States

Hourly Compensation: $19.50

(this position is bonus eligible)

Schedule:

Full-Time, M-F 8am-4pm Central

The Revenue Cycle Medical Billing Commercial Appeal Specialist supports the functions of the Appeal team by assisting in the review of denied and underpaid claims for the formal appeal and dispute process with the payor. Responsibilities include, but are not limited to: classification of appeals, research of accounts, preparing documents, obtaining appeal status, and review of appeal determinations.

• Review Explanation of Benefits, denial letters and payor correspondence to classify type of appeal required.
• Gather, prepare, and review documentation & various forms needed to submit appeals correctly per payor guidelines.
• Engage patients via phone and/or mail to obtain requested information pertaining to the appeal process.
• Document the details, requirements, and deadlines of each individual appeal in billing software.
• Mange daily workflow through reports to ensure accounts are processed within required time frames.
• Follow-up with payors regarding status of appeals in a timely manner.
• Identify payor issues within the appeal process and discuss potential improvements and workflow solutions with leadership.

• Must be fluent in English
• Minimum of one (1) year of advanced medical billing experience
• Professional written and verbal communication skills
• Knowledge and experience of computers and related technology
• Ability to work independently with little or no direction and as a member of a team

• High School diploma or equivalent, or significant relevant work experience

• Call Center environment work experience
• Above average knowledge of insurance billing guidelines and policies
• Experience with Commercial Insurance appeal and reconsideration processes

• Knowledge of health care billing procedures, reimbursement, third party payer regulations, documentation, and standards
• Understanding and interpretation of Explanation of Benefits (EOB) from payors
• Strong problem-solving skills, attention to detail, and ability to make timely decisions
• Excellent internal and external customer service skills
• Responsiveness and a strong commitment to meeting internal and external deadlines with limited supervision

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Global Medical Response and its family of companies are an Equal Opportunity Employer, which includes supporting veterans and providing reasonable accommodations for individuals with a disability.

Check out our careers site benefits page to learn more about our benefit options.