Appeals Specialist

Job Summary

A company is looking for an Appeals Specialist responsible for reviewing denied claims and maximizing reimbursement for specialized laboratory services.

Key Responsibilities

• Review and analyze denied claims to assess appeal potential
• Communicate with healthcare providers and insurance representatives to gather necessary documentation for appeals
• Monitor and follow up on submitted appeals to ensure timely resolution

Required Qualifications

• 3-5 years of experience in laboratory billing appeals
• Strong understanding of insurance policies and healthcare regulations
• Expertise in appeals process for major insurance plans, Medicaid, and Managed Medicaid
• Knowledge of industry regulations, including HIPAA
• Experience with Xifin is a plus