Medical Billing Appeal Medicaid/Workers Compensation Follow Up Specialist
On-Site or Remote
Starting Pay $18.00
Job Summary
The Medical Billing Appeal Medicaid/Workers Compensation Follow Up Specialist will follow-up on appeal status with traditional Medicaid, MCOs, and Workers Compensation payors in a timely manner to achieve maximum reimbursement on claim denied for medical necessity, closest appropriate, and/or air versus ground.
Essential Functions/ Duties
Conducts online and phone follow-up on pending appeal responses.
Processes all payor responses to submitted appeals.
Handles inbound/outbound call center calls for payors and patients/guarantors.
Qualifications
Required Experience
Must be fluent in English
Minimum three (3) years of experience in healthcare/revenue cycle billing environment
Above average knowledge of various Medicaid payor billing guidelines and Workers Compensation
Ability to interpret remittance advices/explanation of benefits
Knowledge and experience of computers and related technology, at an intermediate level
Preferred Experience:
Experience with post bill follow up and/or appeals for all Medicaid and Workers Compensation payors
Minimum of one (1) year in a call center environment
Proficient in Word, Excel, Office 365
Required Education
High School diploma or equivalent
Skills
Ability to define and identify problems, collect data, establish facts, and draw valid conclusions
Ability to respond to inquiries or complaints from customers in a positive and productive manner
Ability to calculate numbers, correct entries, and post to records
Ability to gather data, compile information, and prepare reports
Ability to use independent judgment and to manage and impart confidential information
Ability to prepare routine administration
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