Job Details

Claims Review & Analysis: Review denied, rejected, or underpaid insurance claims for therapy services, identifying reasons for denial and determining the appropriate course of action. Appeal Preparation & Submission: Prepare and submit well-documented appeals to insurance companies, including all necessary supporting documentation (e.g., clinical notes, treatment plans, and medical records) to substantiate claims. Collaboration with Providers: Work closely with therapists and other healthcare providers to gather information needed for the appeals process and clarify any inconsistencies or issues with claims. Insurance Follow-up: Maintain regular communication with insurance companies to track the status of pending appeals, resolve issues promptly, and follow up on delayed or outstanding payments. Documentation & Reporting: Maintain accurate records of all appeals and follow-up actions, ensuring compliance with company policies, insurance regulations, and deadlines. Compliance & Knowled...Appeals Specialist, Appeals, Specialist, Healthcare, Remote, Insurance