About this role
Alegis, a MedData Company, seeks an Appeals and Denials Representative with knowledge on appeal process for government plans and managed care insurance. Responsibilities will include but are not limited to:
ESSENTIAL DUTIES AND RESPONSIBILITIES
Review of denial referrals; for early identification of root cause of denial; preliminary determination whether denial can be overturned;
Request of any necessary documentation needed in order to prepare appeals;
Prepare and submit appeals to insurance carriers;
Monitor accounts for updates on claim/appeal status;
Post insurance payments in Account Management software;
Inform supervisor of trends noticed when working denials.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
High School Diploma or GED
1 year experience in hospital billing experience
Able to commute to Katy Texas work location
Certified Biller/Coder Required
Experience with Claim Administrator/Emdeon isstrongly preferred
Able to work Monday through Friday, 8 am-5 pm
Strong computer skills including Microsoft Excel, and Word;
Able to communicate (both written and verbal) in a professional manner;
Ability to multi-task and work with minimal supervision;
Computer savvy, 40 wpm minimum, 10-key by touch, Microsoft Office, internet and ability to quickly learn new systems
Strong interpersonal communication skills, including dealing with patients, clients, insurance companies, etc.
Strong phone etiquette
Must be adaptable to fast paced environment, and always projecting professionalism and expertise
Dependable and self-starter
Must be prompt and presentable
Pay and Benefits
$16-$19 hourly (depending on experience with hospital billing)
Health, Vision and Dental Benefits
Floating Holiday(s) and PTO
7 paid holidays
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an Employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the Employee is frequently required to sit; use hands or fingers to handle, or feel; and react with hands and arms. The Employee is occasionally required to stand and walk and must occasionally lift and/or move up to 50 pounds.
Occasional travel is required.
MedData is an Equal Opportunity Employer