[Hiring] Appeals Representative REMOTE USA
Position: Appeals Representative
Date posted: 2025-05-22
Industry: Health
Employment type: Full Time
Experience: 2 to 3 year
Qualification: High school diploma or equivalent required.
Location: Alcoa, TN ·, United States, REMOTE
Company: TeamHealth
Description:
Hiring Appeals Representative
Alcoa, TN ·
About the job
External Job Description And Responsibilities
JOB DESCRIPTION OVERVIEW:
Position is responsible for reviewing assigned denials to ensure claims are being processed correctly and efficiently.
Essential Duties And Responsibilities
- Reviews assigned denials to determine appropriate action based on payer requirements.
- Assembles and prepares required documentation for appeal in billing system to appeal disputed claims.
- Assembles and forwards required documentation for payer guidelines.
- Maintains working knowledge of carrier requirements for claim appeals and claim appeal billing systems.
- Identifies and report consistent errors that impact claims from being processed correctly.
- Performs additional duties and assignments as requested.
Requirements
Qualifications / Experience
- High school diploma or equivalent required.
- Two-years previous medical billing experience preferred with emphasis on research and claim denials in Accounts Receivable preferred.
- Knowledge of healthcare reimbursement guidelines, ICD-10 and CPT-4 coding, appeals process and physician billing preferred.
- Proficient in Microsoft Office.
- Must possess excellent oral and written communication skills.
- Must be well-organized and possess ability to follow-up on claims.
- Must be self-motivated.
Supervisory Responsibilities
- Physical / Environmental Demands
- Job performed in a well-lighted, modern office setting
- Occasional standing/bending
- Occasional lifting/carrying (20lbs or less)
- Moderate stress
- Prolonged sitting
- Prolonged work on a PC/computer
- Prolonged telephone work
This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, fax) and/or the ability to perform repetitive motions and/or meet production standards to comply with the essential functions. Also, may require physical and/or mental stamina to work overtime, additional hours beyond a regular schedule and/or more than five days per week.
This job will be performed in a well-lighted and well-vented environment. Work is oriented around good visual skills. Eye fatigue may be encountered as extended amount of time is spent in front of computer.
Location
Remote
Job Category
Admin-Clerical, Customer Service, Healthcare
