REACH Air Medical Services
Revenue Cycle Medical Billing Commercial Appeal Specialist
REACH Air Medical Services, West Plains, Missouri, United States, 65775
Revenue Cycle Medical Billing Appeal Specialist - Commercial
Location:
Remote or On-Site (West Plains, MO)
Hourly Pay:
$20
This position is bonus eligible.
Work Schedule:
Training M-F 8am-5pm CST, Flex Hours (after training) M-F 7am-7pm CST
Job Summary The Commercial Appeal Specialist supports the functions of the Revenue Cycle Appeal team by assisting in the review of denied and underpaid claims for the formal appeal and dispute process with the payor. Responsibilities include, but are not limited to: classification of appeals, research of accounts, preparing documents, obtaining appeal status, and review of appeal determinations.
Essential Functions / Duties
Review Explanation of Benefits, denial letters, and payor correspondence to classify type of appeal required.
Gather, prepare, and review documentation and various forms needed to submit appeals correctly per payor guidelines.
Engage patients via phone and/or mail to obtain requested information pertaining to the appeal process.
Document the details, requirements, and deadlines of each individual appeal in billing software.
Use reports to manage daily workflow and ensure accounts are processed within required timeframes.
Timely and regular follow‑up with payors regarding status of appeals – Makes routine phone calls and contact to payor/insurance for status and/or discussion of appeal determination or outcome.
Ability to identify payor issues within the appeal process and discuss potential improvements and workflow solutions with leadership.
Additional duties as assigned.
Qualifications Required Experience
Must be fluent in English
Minimum of one (1) year of medical billing experience
Professional written and verbal communication skills
Knowledge of navigating insurance payor portals
Ability to verify insurance claim status and complete medical records
Knowledge and experience of computers and related technology at an intermediate level
Ability to work independently with little or no direction and as a member of a team
Preferred Experience
Minimum of one (1) year working in a call center environment
Above average knowledge of insurance billing guidelines and policies
Experience with Commercial Insurance processes and policies
Experience with BCBS Insurance
Preferred Education
High school diploma
GED
Or significant, relevant work experience
EEO Statement Global Medical Response and its of companies are an Equal Opportunity Employer, which includes supporting veterans and providing reasonable accommodations for individuals with a disability.
Check out our careers site benefits page to learn more about our benefit options.
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Location:
Remote or On-Site (West Plains, MO)
Hourly Pay:
$20
This position is bonus eligible.
Work Schedule:
Training M-F 8am-5pm CST, Flex Hours (after training) M-F 7am-7pm CST
Job Summary The Commercial Appeal Specialist supports the functions of the Revenue Cycle Appeal team by assisting in the review of denied and underpaid claims for the formal appeal and dispute process with the payor. Responsibilities include, but are not limited to: classification of appeals, research of accounts, preparing documents, obtaining appeal status, and review of appeal determinations.
Essential Functions / Duties
Review Explanation of Benefits, denial letters, and payor correspondence to classify type of appeal required.
Gather, prepare, and review documentation and various forms needed to submit appeals correctly per payor guidelines.
Engage patients via phone and/or mail to obtain requested information pertaining to the appeal process.
Document the details, requirements, and deadlines of each individual appeal in billing software.
Use reports to manage daily workflow and ensure accounts are processed within required timeframes.
Timely and regular follow‑up with payors regarding status of appeals – Makes routine phone calls and contact to payor/insurance for status and/or discussion of appeal determination or outcome.
Ability to identify payor issues within the appeal process and discuss potential improvements and workflow solutions with leadership.
Additional duties as assigned.
Qualifications Required Experience
Must be fluent in English
Minimum of one (1) year of medical billing experience
Professional written and verbal communication skills
Knowledge of navigating insurance payor portals
Ability to verify insurance claim status and complete medical records
Knowledge and experience of computers and related technology at an intermediate level
Ability to work independently with little or no direction and as a member of a team
Preferred Experience
Minimum of one (1) year working in a call center environment
Above average knowledge of insurance billing guidelines and policies
Experience with Commercial Insurance processes and policies
Experience with BCBS Insurance
Preferred Education
High school diploma
GED
Or significant, relevant work experience
EEO Statement Global Medical Response and its of companies are an Equal Opportunity Employer, which includes supporting veterans and providing reasonable accommodations for individuals with a disability.
Check out our careers site benefits page to learn more about our benefit options.
#J-18808-Ljbffr