We are actively seeking an Appeals Specialist to join our team in Glen Allen, VA ASAP!
We are a national healthcare organization with several locations throughout the states! This is a 3+ month contract to start, with no promise to extend or go perm.
If you’re interested in hearing more, please apply today!
Requirements for Appeals Specialist :
- 2+ years of insurance appeals Experience
- Ability to research and interpret state laws as they pertain to the collection of fees for services rendered.
- Ability to draft appeal letters to be sent to parents or insurance companies.
- Ability to communicate professionally and thoroughly with staff, parents, insurance companies, business partners and other parties.
Daily Responsibilities for Appeals Specialist :
- The Appeals Specialist is responsible for appealing insurance payments limited by a UCR adjustment.
- This process could be on behalf of the parent or in conjunction with a parental appeal.
- On a daily basis, the associate will review accounts, identify any appealable charges, and post appropriate transaction code for follow up.
- The collections effort on appealed accounts includes; telephone contact with payers, employer benefit managers and parents, working daily and monthly reports, researching and reviewing state statutes that would present an arguable case on the companies behalf and developing and submitting cover letters with appeal packets to payer or parent for additional reimbursement.
- Performs required tasks on GPMS, Excel and Word.
- Make necessary telephone or written contact.
- Contact payers to dispute underpaid accounts which are >$1,000.
- Develop cover letters to submit with appeal packets to payers.
- When necessary, obtain Assignment of Benefit Form from parents to appeal directly with the insurance company.
- Follow up monthly on packets forwarded for appeals to assure additional monies recovered.
- Consistent follow-up on identified short paid accounts through working daily and monthly appeal reports.
Hours for Appeals Specialist :
Monday - Friday 8am - 5pm
Advantages of this Opportunity:
Full medical benefits offered
If you’re interested in speaking in more detail, please apply today! We are scheduling interviews ASAP.