Job Description

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Revenue Cycle Medical Billing - Financial Appeal Writer - BCBS

Location: Remote or On-Site

Hourly Pay: $20

(this position is bonus eligible)

Work Schedule: Full-Time

The Financial Appeal Writer 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, writing of appeal, appeal submission, 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 & various forms needed to submit appeals correctly per payor guidelines. Write formal appeal using information and documentation specific to each account based on the denial type & appeal submission based on payor specific 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. Manage daily workflow through report usage and ensure accounts are processed within required timeframes. Follow-up in a timely manner, regularly with payors regarding status of appeals. Identify payor issues within the appeal process and discuss potential improvements and workflow solutions with leadership.

Skills:

Knowledge of health care billing procedures, reimbursement, third party payer regulations, documentation, and standards. Knowledge of Blue Cross Blue Shield and Commercial Insurance payors is a plus Understanding and interpretation of Explanation of Benefits (EOB) from payors Strong problem-solving skills, attention to detail, and ability to make timely decisions Excellent internal and external customer service skills Responsiveness and a strong commitment to meeting internal and external deadlines with limited supervision

Qualifications:

Required Experience

Must be fluent in English Minimum of one (1) year of advanced medical billing experience Minimum of one (1) year experience with formal appeal writing and reconsideration processes for Commercial Insurances Knowledge and experience of computers and related technology Professional written and verbal communication skills Ability to work independently with little or no direction and as a member of a team

Preferred (Not Required) Experience

Minimum of one (1) year working in a call center environment Above average knowledge of insurance billing guidelines and policies

Preferred Education:

High School diploma GED Or significant relevant work experience

Why Choose GMR? Global Medical Response (GMR) and its family of solutions are dedicated to delivering compassionate, quality medical care, primarily in the areas of emergency and patient relocation services. Here you'll embark in meaningful work that will make an impact on you and the customers we serve. View our employees' stories on how we provide care to the world at www.AtaMomentsNotice.com.
EEO Statement:
Global Medical Response and its family of companies are an Equal Opportunity Employer, which includes supporting veterans and providing reasonable accommodations for individuals with a disability.


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