Appeals Specialist
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Job Location:
Clearwater, SC - USA
Monthly Salary:
Not Disclosed
Posted on:
Yesterday
Vacancies:
1 Vacancy
Department:
Job Summary
General Description (Duties & Responsibilities)
The Appeals Specialist is critical to ensuring accurate and timely resolution of insurance claims and appeals for our medical devices contributing directly to our financial health and patient satisfaction.
Review and analyze denied insurance claims to determine appropriate appeal strategies.
Prepare and submit appeals to insurance providers ensuring compliance with payer guidelines and timelines.
Collaborate with billing coding and clinical teams to gather necessary documentation for appeals.
Monitor appeal outcomes and follow-up on unresolved cases.
Maintain accurate records of all claims and appeals activity in the system.
Performs other related duties as required or our financial health and patient satisfaction.
Qualifications
Skills & Abilities
Excellent written and verbal communication skills.
Ability to work independently and manage multiple priorities in a fast-pacedenvironment.
Work Experience Requirements
Proven experience in medical billing claims processing or revenue cyclemanagement preferably in a medical device or healthcare setting.
Deep understanding of insurance guidelines EOBs and appeal processes.
Direct Reports
N/A
Physical Demands and Working Conditions
Ability to sit at a computer terminal for an extended period.
Moderate noise (i.e. phone calls online meetings computer audio)
While performing the duties of this job the employee may be regularly required to stand sit talk hear reach stoop kneel and use hands and fingers to operate a computer telephone and keyboard.
Specific vision abilities required by this job include close vision requirements due to computer work.
Regular predictable attendance is required.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Reasonable accommodation requests must be made in writing by emailing
Required Experience:
IC
Key Skills
- Sales Experience
- Crane
- Customer Service
- Communication skills
- Heavy Equipment Operation
- Microsoft Word
- Case Management
- OSHA
- Team Management
- Catheterization
- Microsoft Outlook Calendar
- EHS
