Job Opening: Appeals Representative

Job Summary

This role focuses on reviewing denied medical claims and taking the necessary steps to appeal and correct them, ensuring claims are processed accurately and efficiently.

Key Responsibilities

• Review denied claims and decide the next steps based on insurance guidelines
• Prepare and submit documentation for appeals
• Ensure all paperwork follows the payer’s requirements
• Stay updated on appeal processes and insurance rules
• Report recurring errors that affect claims
• Complete other tasks as needed

Qualifications

• High school diploma or equivalent (required)
• 2+ years of medical billing experience, especially in denials or A/R (preferred)
• Understanding of healthcare billing, insurance reimbursement, ICD-10/CPT codes, and appeals (preferred)
• Proficient in Microsoft Office
• Strong written and verbal communication
• Organized, detail-oriented, and self-motivated