Note: The job is a remote job and is open to candidates in USA. Med-Metrix is a company that supports client hospitals by reviewing insurance claims denied for payment. The Licensed Appeal Writer will create appeal letters in collaboration with nurses and other team members to reverse claim denials.
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
Skills
- 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
Company Overview