Healthcare Appeals Specialist
2 weeks ago
Job Overview
We are seeking a skilled Healthcare Appeals Specialist to join our team at LHH Recruitment Solutions in Phoenix, AZ.
About the Role
This is a direct hire position with a competitive hourly rate of $21.00-$24.00 per hour. The successful candidate will be responsible for evaluating medical claims denied by insurance companies or other payers and developing effective appeal strategies.
Key Responsibilities
- Evaluate medical claims denied by insurance companies or other payers.
- Conduct thorough research to identify reasons for denial and develop effective appeal strategies.
- Prepare and submit appeals to relevant parties, including insurance companies and government agencies.
- Organize and compile medical documentation to support appeals, such as medical records and physician notes.
- Facilitate communication between patients, healthcare providers, and insurance companies to gather necessary information and provide updates on appeal status.
- Monitor appeal progress and ensure all deadlines are met.
- Analyze denial trends and devise strategies to minimize future denials.
- Participate in quality improvement initiatives to enhance the appeals process.
- Ensure compliance with regulatory requirements, including HIPAA and Medicare guidelines.
Qualifications
- Minimum 5 years of experience in medical billing/collections.
- Proficiency in processing Medicare, Managed Care, and Worker's Comp claims.
- Extensive background in medical appeals, including navigating patient account systems and revenue management processes.
- Strong organizational and problem-solving skills.
Benefits
- Competitive hourly rate of $21.00-$24.00 per hour.
- A comprehensive benefits package, including medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits, and 401K plan.
- Flexible scheduling, Monday to Friday, 6am-4pm.
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