What are the responsibilities and job description for the Medical Biller - Audit and Appeals Specialist position at Tropical Sky Orthotics & Prosthetics?
About Tropical Sky Orthotics & Prosthetics
Founded in 2017, Tropical Sky Orthotics & Prosthetics provides prosthetic, orthotic, and diabetic shoes to patients through Central Florida in one of our four office locations or at patient homes. Tropical is experiencing significant growth each year, and seeks to add staff who align with our mission of Right Care, Right Place, Right Time. Tropical employees are excited about our welcoming company culture that includes frequent company-sponsored team outings and events providing opportunities to meet and engage with the broader team. We believe in continuing education, supporting you as you set and achieve career goals, and we provide significant cross training and development opportunities within our organization.
About the Role
As the Medical Billing Audit and Appeals Specialist, your primary responsibility is to appeal claim and authorization denials received from insurance companies. This role reports to the Billing Documentation Manager and will be based in our Maitland office location, with opportunities to visit our other offices in Kissimmee, Ocala, and Deland as useful.
Key Responsibilities:
- Compile existing documentation and write appeals for both claim denials and authorization denials, including submission to insurance companies with follow up as needed.
- Call insurance companies to understand and process denials as needed.
- Work together with manager to keep leaders aware of common denial reasons and suggestions on how to limit denials.
- Stay up to date on coverage criteria changes.
- Update tracking and audit systems.
- Support revenue cycle functions, including benefits and eligibility verification, documentation review, claims submission and posting, etc.
Qualification and Education Requirements
- 2 years of experience in a similar role submitting appeals and completing audit defense
- Excellent written communication in English
- Microsoft Office experience
- EHR experience
- High school diploma
Preferred experience:
- 2-4 years of experience in Orthotics/Prosthetics industry strongly preferred.
- OPIE EHR and Salesforce CRM experience
Salary: $37,500 - $47,000 per year (based on experience)
Job Type: Full-time
Pay: $18.00 - $22.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Experience:
- medical billing: 2 years (Required)
- Orthotics/Prosthetics: 2 years (Preferred)
Ability to Commute:
- Maitland, FL 32751 (Required)
Ability to Relocate:
- Maitland, FL 32751: Relocate before starting work (Required)
Work Location: In person
Salary : $37,500 - $47,000