Licensed Appeal Writer
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Job Description
Licensed clinician reviewing denied hospital insurance claims and writing appeals. Analyzing medical records and managing deadline-driven workflows for Med-Metrix.
Responsibilities:
- Review denied insurance claims
- Review patients' medical files
- Develop strategies to reverse claim denials
- Create written appeals
- Manage and organize appeal workflow according to internal, client-based, and insurance-driven deadlines
- Use, protect, and disclose patients' protected health information only in accordance with HIPAA standards
- Comply with Information Security and HIPAA policies and procedures
- Limit viewing of protected health information to the minimum necessary
- Perform other duties as assigned
Requirements:
- 4-year degree or work equivalency required
- Must hold an active license as a Physician's Assistant (PA), Registered Nurse (RN), Nurse Practitioner (NP), Licensed Practical Nurse (LPN), Physical Therapist (PT), Occupational Therapist (OT), or an equivalent professional license
- Ability to prioritize workload based on strict deadlines
- Tech-savvy and able to quickly learn new software
- High reading comprehension and ability to analyze medical information and terminology
- Proficiency in Microsoft Office Suite
- Strong interpersonal and communication skills
- Strong problem-solving and creative skills; ability to exercise sound judgment and make decisions based on accurate and timely analyses
- High integrity and dependability, with a strong sense of urgency and results orientation
- Excellent written and verbal communication skills
- Gracious and welcoming personality for customer service interaction
- Smartphone or electronic device capable of downloading applications for multifactor authentication and security purposes
- Ability to follow directions, collaborate with others, and handle stress
Benefits:
- No specific benefits or compensation extras stated
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