Medical Billing Appeals Specialist

Medloop
Mahwah, NJ Full Time
POSTED ON 3/21/2023 CLOSED ON 10/18/2023

What are the responsibilities and job description for the Medical Billing Appeals Specialist position at Medloop?

Medloop a large multi-specialty medical billing company servicing many clients across the US mostly in NY/NJ is looking for a talented and highly motivated Medical Billing Appeals Representative to resolve billing issues and work directly with clients to identify and manage efficient billing processes for optimal A/R outcomes. They also manage a broad array of projects in relation to claims resolution, payer tracking, website access, claims status inquiries, and direct carrier contact.

RESPONSIBILITIES:

·              Serve as a liaison between patient, insurer, and practice

·              Follow-up on patient accounts to assure claims for patient charges submitted to insurance companies are paid in a timely fashion

·              Initiates prior authorization for all procedures requested by staff, providers, and or insurers.

·              Prioritize and organizes all prior authorization activities

·              Documents all prior authorization activities and record activity

·              Excellent communication and organizational skills with a customer service focus

·              Ability to read and understand EOB’s and ERA files

·              Processing appeals

·              Analyze and research denials

·              Knowledge of CPT and ICD10 coding requirements

·              Previous experience in a medical industry Is required

·              Understanding of refunds/take-backs

·              Knowledge of medical terminology

·              Must have the ability to maintain confidential information

·              Must have the ability to multitask and take initiative

·              Must be able to identify and communicate billing inconsistencies

REQUIRED MINIMUM QUALIFICATIONS:

·              High school diploma, or equivalent

·              2 years of medical billing experience, or medical billing training, or other experience in a healthcare setting

PREFERRED ADDITIONAL QUALIFICATIONS (not required):

·              Working knowledge of Medicare, Medicaid, and Commercial payor claims and appeals processing requirements

·              Familiar with writing appeals with successful outcomes

·              General knowledge of ICD-10, CPT-4, and HCPC coding and CCI edits

·              Ability to prioritize effectively and handle shifting priorities

·              Self-starter with the ability to organize work for maximum efficiency and attention to quality

At Medloop we offer great opportunities with the potential for growth. 

 

Benefits: 

  • Health Insurance
  • 401K
  • Great PTO Package

Job Type: Full-time (In the office - Not Remote)

Pay: $22-$26 per hour

 

 

 

 

 

 

 

 

 

 

 

 

Salary : $22 - $26

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