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Appeals Specialist

World Travel & Connect

Medical Data Systems Inc. is seeking a detail-oriented and motivated Insurance Specialist to join its insurance support and billing team. The role focuses on insurance follow-up, claim submission, denial appeals, account maintenance, and supporting collections efforts in a fast-paced healthcare environment.

Responsibilities include:

  • Perform insurance follow-up activities, including claim submission, claim status inquiries, and filing appeals for denied claims
  • Process a high volume of detailed account information accurately and within established performance guidelines
  • Navigate multiple systems to obtain insurance, contact, and attorney information as needed
  • Support collections prioritization by updating account data and identifying next steps
  • Maintain confidentiality and comply with HIPAA regulations
  • Apply hospital billing knowledge to assigned duties
  • Correct and resubmit claims, file appeals, and contact insurance companies, attorneys, or patients regarding outstanding balances
  • Work assigned facility-specific queues and keep account information complete and accurate
  • Assist with special projects and provide support to colleagues and management as needed
Requirements & Qualifications

Required qualifications include:

  • 3-5 years of experience in a healthcare setting such as a hospital business office, surgery center, physician practice, or health insurance organization
  • Strong communication skills, attention to detail, and self-motivation
  • Knowledge of insurance processes, including claim submission, denials, claim status inquiries, and basic HCPCS/CPT/ICD-10 coding
  • Familiarity with Medicare, Medicaid, commercial plans, auto, workers' compensation, liability, crime victims, and state/federal insurance programs
  • Experience with medical billing and collection practices, business office procedures, and multi-system computer navigation
  • Ability to type at least 55 words per minute
  • High school diploma or GED required; some college preferred

Location

Georgia, US

Employment Type

Full-time

Experience Level

Senior

Remote work allowed

No

Posted

2 months ago

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