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