Appeals Specialist

Oms Medical Billing; Addison (TX); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

Company-paid life insurance

401(k) with 3% company contributions

Professional development opportunities

Job summary

Oms Medical Billing in Addison, TX is hiring an Appeals Specialist. This full-time position requires on-site presence during regular business hours at our corporate office.

The ideal candidate will review denied claims, prepare and submit appeal letters, and communicate with insurance companies and patients. Strong knowledge in medical terminology and 2+ years of relevant experience are essential. The role offers competitive compensation and benefits including health, dental, and vision insurance.

Qualifications

• 2+ years of experience in medical billing, claims processing, or appeals management.
• Familiarity with insurance policies, Medicare, and Medicaid regulations.
• Strong knowledge of CPT and ICD-10 coding.

Responsibilities

• Review denied claims and determine appropriate appeal strategies.
• Prepare and submit appeal letters with supporting documentation.
• Follow up on pending appeals and track their progress.

Skills

Strong knowledge of medical terminology

Excellent written and verbal communication skills

Strong analytical and problem-solving abilities

Proficiency in Microsoft Office

Education

Bachelor's degree in Healthcare Administration or related field

Tools

Medical billing software

Job description

Job Overview

OrthoMed Anesthesia, located in Addison, TX, is seeking a detail-oriented Appeals Specialist. The role is full-time and requires on-site presence during regular business hours at our corporate office.

Key Responsibilities

• Review denied claims and determine appropriate appeal strategies.
• Prepare and submit appeal letters with supporting documentation.
• Follow up on pending appeals and track their progress.
• Communicate with insurance companies, healthcare providers, and patients regarding appeal status.
• Maintain accurate records of all appeal activities.
• Analyze appeal outcomes and identify trends to improve the appeals process.
• Stay updated on insurance policies, regulations, and appeal procedures.

Qualifications

• Bachelor's degree in Healthcare Administration, Business, or related field (or equivalent experience).
• 2+ years of experience in medical billing, claims processing, or appeals management, preferably in anesthesia or a related specialty.
• Strong knowledge of medical terminology, CPT, and ICD-10 coding.
• Familiarity with insurance policies, Medicare, and Medicaid regulations.
• Excellent written and verbal communication skills.
• Strong analytical and problem-solving abilities.
• Proficiency in Microsoft Office suite and medical billing software.

Benefits

Competitive compensation. Health, dental, and vision insurance. Company-paid life insurance. 401(k) with 3% non-discretionary company contributions. Professional development opportunities.