Healthcare Appeals Specialist

2 weeks ago


Phoenix, Arizona, United States LHH Recruitment Solutions Full time

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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