Appeal Writer – Hospital Billing, Denials

This is a fully remote position, open to applicants in Florida.

📋 Description

• Analyze denied claims to uncover root causes and devise suitable appeal strategies.

• Prepare and submit both electronic and written appeals to insurance companies.

• Follow up with third-party payers regarding the status and resolution of claims.

• Investigate insurance benefits, eligibility, and claim details across various service lines.

• Resolve accounts accurately and efficiently to optimize reimbursement.

• Research and confirm billing adjustments, contractual provisions, and administrative corrections.

• Communicate with insurance carriers, hospitals, VA facilities, patients, and internal stakeholders to address claims issues.

• Maintain precise documentation of claim activities, appeal submissions, and their outcomes.

• Identify contractual and administrative modifications and take necessary actions.

• Work autonomously and collaboratively to meet productivity and quality objectives.

• Adhere to organizational policies, payer guidelines, and regulatory standards, including HIPAA compliance.

• Participate in cross-training across service lines and assist with additional operational tasks as needed.

• Access hospital EMRs and payer portals to gather clinical documentation, verify claim specifics, and support thorough appeal submissions.

• Contribute to reducing denials, maintaining revenue integrity, enhancing operational efficiency, improving cash flow, decreasing accounts receivable aging, and minimizing revenue loss.

• Identify denial patterns, collaborate with cross-functional teams, and enhance appeal success rates.

⛳️ Requirements

• A high school diploma or equivalent is required.

• Strong analytical and critical thinking skills for evaluating denial root causes.

• Excellent written and verbal communication abilities for crafting clear and persuasive appeal letters.

• Capacity to multi-task and manage competing priorities effectively.

• Strong organizational and time management capabilities.

• Effective documentation and follow-up skills.

• Ability to research and interpret insurance information and benefits.

• Keen attention to detail and accuracy in documentation and appeal preparation.

• Active listening and customer service expertise.

• Ability to work independently in a fast-paced setting.

• Reliable attendance and consistent performance are essential.

• Ability to learn quickly and adapt to shifting priorities.

• A bachelor’s degree is preferred, or an equivalent combination of education and experience.

• Experience in revenue cycle management or healthcare operations is advantageous.

• Experience in insurance follow-up, denials, or appeals is preferred.

• Familiarity with various insurance carriers and payer guidelines.

• Experience in a productivity and quality metrics-driven environment.

• Remote work experience in a structured setting is desirable.

• Experience working across multiple service lines is a plus.

• Ability to identify trends and opportunities for process improvement.

• Experience with EMR systems such as Epic or similar platforms is preferred.

• Prior experience in healthcare revenue cycle or denial management settings is essential.

• Adherence to HIPAA, GLBA, FCRA, and other relevant laws is mandatory.

• US-based remote employees must not work outside the United States without prior written consent.

🏝️ Benefits

• An indefinite contract role with no fixed end date, continuing based on ongoing business needs.

• Opportunity to work remotely.

• Cross-training across service lines available.

• Continuous growth, feedback, and learning opportunities provided.

• Equal Opportunity Employer commitment.

• Reasonable accommodations for individuals with disabilities.