Licensed Appeal Writer - Remote at Med-Metrix

Garden City, New York, United States -

Full Time

Start Date

Immediate

Expiry Date

05 Sep, 26

Salary

85000.0

Posted On

07 Jun, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Appeals Writing, Claim Denial Review, Medical Terminology, HIPAA Compliance, Microsoft Office Suite, Medical File Analysis, Problem Solving, Written Communication, Interpersonal Skills, Case Management

Industry

Hospitals and Health Care

Description

Job Purpose The Licensed Appeal Writer supports the Company by reviewing insurance claims denied for payment on behalf of our client hospitals. Working closely with nurses and other team members, the Licensed Appeal Writer creates appeal letters in support Duties & Responsibilities Review denied insurance claims Review patients’ medical files Develop strategies to reverse claim denials Create written appeals Manage and organize appeal workflow based on internal, client-based, and insurance-driven deadlines Other duties as assigned Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards Understand and comply with Information Security and HIPAA policies and procedures at all times Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties Qualifications 4-year degree or work equivalency required Must hold an active license as a Physician's Assistant (PA), Registered Nurse (RN), Nurse Practitioner (NP), Licensed Practical Nurse (LPN), Physical Therapist (PT), Occupational Therapist (OT), or an equivalent professional license Must be able to prioritize workload based on strict deadlines Must be tech-savvy with ability to quickly learn new software Must possess a high level of reading comprehension and ability to analyze medical information and terminology Proficiency in Microsoft Office Suite Strong interpersonal skills, ability to communicate well at all levels of the organization Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses High level of integrity and dependability with a strong sense of urgency and results oriented Excellent written and verbal communication skills required Gracious and welcoming personality for customer service interaction Working Conditions Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes. Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear. Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress. Work Environment: The noise level in the work environment is usually minimal. Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

Responsibilities

The Licensed Appeal Writer reviews denied insurance claims and patient medical files to develop strategies for reversing denials. They are responsible for creating written appeal letters and managing the workflow to meet strict internal and insurance deadlines.