Insurance Appeal Advocate

3 weeks ago


Cambridge, Massachusetts, United States Ternium Full time

Job Description: We are looking for a skilled Insurance Appeal Advocate to join our team at Ternium. As an Insurance Appeal Advocate, you will be responsible for developing and implementing strategies to resolve denied medical claims. Your expertise in commercial and managed care insurance claims policies and procedures, as well as ERISA regulations, will enable you to effectively navigate the complexities of administrative appeal processes.

Key Responsibilities:

  • Represent healthcare providers in denied claim disputes.
  • Develop and implement effective strategies to resolve denial medical claims.
  • Draft and submit comprehensive appeal letters to insurance organizations and benefit administrators.
  • Collaborate with provider representatives and enhanced resolution units to resolve complex issues.
  • Provide training and education to recovery staff team members at partner provider organizations.

Requirements:

  • Juris Doctor degree
  • State Bar Membership (preferred)
  • Strong analytical and problem-solving skills
  • Excellent written and verbal communication skills

Benefits:

  • Full-time remote position
  • Starting salary $55,000-$65,000 per year (commensurate with experience)
  • 401(k) with corporate match
  • Dental insurance
  • Employee assistance program
  • Flexible schedule
  • Health insurance
  • Vision insurance
  • Life insurance
  • Paid time off
  • Bar Due reimbursement
  • Bonus opportunities


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