Appeal Writer – Hospital Billing, Denials

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

📋 Description

• Analyze denied claims and perform research to determine the root cause and suitable appeal strategy.

• Prepare and send electronic and written appeals to insurance providers.

• Follow up with third-party payers to ascertain claim status and facilitate resolution.

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

• Resolve accounts efficiently and accurately to optimize reimbursement.

• Investigate and confirm billing adjustments, contractual terms, and administrative corrections.

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

• Maintain precise documentation of claim actions, appeal submissions, and results.

• Identify contractual and administrative adjustments and take necessary actions.

• Work both independently and collaboratively to meet productivity and quality objectives.

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

• Cross-train across service lines and assist with additional operational demands as assigned.

• Access hospital EMRs and payer portals to gather clinical documentation, verify claim information, and assist in crafting comprehensive appeal submissions.

⛳️ Requirements

• High school diploma or equivalent is mandatory.

• Strong analytical and critical thinking abilities to assess denial root causes.

• Excellent written and verbal communication skills, capable of producing clear and convincing appeal letters.

• Ability to juggle multiple tasks and prioritize effectively.

• Strong organizational skills and time management capabilities.

• Proficient documentation and follow-up abilities.

• Capacity to research and interpret insurance information and benefits.

• High attention to detail and accuracy in both documentation and appeal preparation.

• Active listening and customer service skills.

• Ability to work independently in a dynamic environment.

• Reliable attendance and consistent performance are essential.

• Quick learner with the ability to adjust to shifting priorities.

• Bachelor’s degree preferred or equivalent combination of education and experience.

• Experience in revenue cycle management or healthcare operations.

• Background in insurance follow-up, denials, or appeals.

• Familiarity with insurance carriers and payer guidelines.

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

• Remote work experience in a structured environment.

• Experience working across multiple service lines.

• Proven ability to identify trends and opportunities for process improvement.

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

• Previous experience in healthcare revenue cycle or denial management settings.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and growth.

• Flexible work arrangements, including remote work options.

• Supportive and collaborative work environment.