Appeals Specialist
医疗数据系统公司正在寻找一个细节化和有动机的保险上诉专家，加入我们的保险支持和结算团队。理想的候选人将在快速发展环境中表现出专业精神，独立性和强烈理解保险流程。关键责任 · 执行保险后续活动，包括提交索赔，询问索赔状况以及申请拒绝索赔。· 正确处理大量详细账户信息并在既定的绩效指南范围内。·根据需要浏览多个系统以获得保险，联系方式和律师信息。· 支持通过精确更新账户数据和确定下一步的步骤来优先考虑收费工作。·保持最高水平的保密性，并遵守所有 HIPAA 规定。·应用医院结算知识以有效地执行分配任务。基本职责 ·完成与保险相关的工作，如纠正和重新提交索赔，申诉，以及联系保险公司，律师或患者关于未偿还余额。· 工作指定设施特定队列，确保所有的帐户都会得到准确和完整的信息更新。· 根据指示参与特殊项目或任务。· 协助同事和管理人员提供与保险流程相关的信息或支持，必要时。资格 · 在医院商务办公室，手术中心，医生实践或健康保险组织等卫生保健环境中经验3-5年。· 有强大的沟通技能，细节关注和自我激励。· 熟练了解保险流动，包括索赔提交，拒绝索赔，HCPCS/CPT/ICD-10编码基础以及索赔状态查询。· 对医疗保险/医疗补助，商业，汽车，工人赔偿，责任，犯罪受害者和州/联邦保险计划的熟悉性。· 医疗费用和收取实践，商务办公室程序以及多系统计算机导航的经验。· 每分钟至少输入55字的能力。· 高中文凭或学历要求；一些大学优先。职位详情·工作类型：全日制 原始地在喜马拉雅山上发布
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Medical Data Systems Inc. is seeking a detail-oriented and motivated Insurance Appeals Specialist to join our insurance support and billing team. The ideal candidate will demonstrate professionalism, independence, and a strong understanding of insurance processes while thriving in a fast-paced environment.
Key Responsibilities
· Perform insurance follow-up activities, including claim submission, claim status inquiries, and filing appeals for denied claims.
- Process a high volume of detailed account information accurately and within established performance guidelines.
- Navigate multiple systems to obtain insurance, contact, and attorney information as needed.
- Support the prioritization of collections efforts by accurately updating account data and identifying next steps.
- Maintain the highest level of confidentiality and adhere to all HIPAA regulations.
- Apply hospital billing knowledge to carry out assigned duties efficiently.
Essential Duties
· Complete insurance-related tasks such as correcting and resubmitting claims, filing appeals, and contacting insurance companies, attorneys, or patients regarding outstanding balances.
- Work assigned facility-specific queues, ensuring all accounts are updated with correct and complete information.
- Participate in special projects or assignments as directed.
- Assist colleagues and management by providing information or support related to insurance processes when needed.
Qualifications
· 3-5 years of experience in a healthcare setting such as a hospital business office, surgery center, physician practice, or health insurance organization.
- Strong communication skills, attention to detail, and self-motivation.
- Proficient knowledge of insurance processes, including claim submission, claim denials, HCPCS/CPT/ICD-10 coding basics, and claim status inquiries.
- Familiarity with Medicare/Medicaid, Commercial, Auto, Workers’ Compensation, Liability, Crime Victims, and State/Federal Insurance Programs.
- Experience with medical billing and collection practices, business office procedures, and multi-system computer navigation.
- Ability to type at least 55 words per minute.
- High School Diploma or GED required; some college preferred.
Position Details·
Employment Type: Full-Time
Originally posted on Himalayas