Appeals Specialist
Core
Managing insurance claim appeals to ensure reimbursement for molecular and genetic testing services.
Role type
Appeals Specialist
Builds
Revenue cycle success and payer compliance
Domain
Healthcare revenue cycle / Insurance billing
Deliverable
client delivery
Required skills
Insurance appeals management, denial management, payer guidelines knowledge, billing systems proficiency, regulatory compliance (HIPAA), written communication, critical thinking
Preferred skills
Molecular/genetic testing billing experience, Associate's or Bachelor's degree
Technologies
Microsoft Office Suite
Responsibilities
Review denied claims and determine appeal strategies, prepare and submit appeal documentation, track appeal status and follow up with payers, research payer policies and identify denial trends, collaborate with prior authorization and billing teams
Seniority
Individual Contributor, 2+ years experience