Job description
The Billing Appeals Specialist works directly with insurance companies, healthcare providers and patients to assure that medical claims are processed correctly and paid timely. They work to review and appeal any unpaid or denied claims and resolve disputes to assure patients aren't out of pocket more than they should be and the providers are paid appropriately
To be successful in this role you will:
- Identify and resolve problems by gathering & analyzing information & developing solutions
- Resolve conflicts with others with open mindedness
- Engage in excellent customer service skills
- Have knowledge of coding, medical terminology and CMS & Commercial billing guidelines
- Maintain confidentiality
Competencies
- Problem solving skills
- Excellent oral and written communication skills
- Knowledge of CPT-4, ICD-10, HC{CS coding & medical terminology
- Strong organizational skills
- Ability to work independently as well as in a group setting
Education
- College Degree preferred but not required
- Certified Medical Coder preferred but not required
- High School Diploma
Experience
- 2 years of recent medical billing office experience preferred
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