Appeals Specialist

Healthcare Support Staffing; Tacoma (WA); On-site; USD 34,000 - 44,000; Full time

Benefits offered by this job

Competitive hourly pay

Longterm stability

Professional growth opportunities

Job summary

A national healthcare staffing firm is seeking a Medical Appeals Specialist in Tacoma, WA. The role involves validating denial reasons, managing insurance claims, and following up on appeals. Candidates should have 1-2 years in healthcare admin, 3-5 years of A/R experience, and excellent Excel skills. This position offers competitive pay and long-term growth opportunities within a prestigious organization. Join a team that values your expertise and contributes to your professional journey.

Qualifications

• 1-2 years in a healthcare administrative environment performing billing and/or collections.
• 3-5 years of A/R follow up with insurance on claims.
• Full understanding of the insurance denials/appeals process.
• Excellent computer skills with emphasis on use of Excel spreadsheets.

Responsibilities

• Validate denial reasons and ensure accurate coding.
• Coordinate clinical consultations as needed.
• Generate appeals based on dispute reasons.
• Follow payer guidelines for appeals submission.
• Escalate exhausted appeal efforts for resolution.
• Review EOBs to determine denials.
• Work payer projects as directed.

Skills

Healthcare billing and collections knowledge

A/R follow-up experience

Understanding of insurance denials

Proficient in Excel

Tools

Microsoft Excel

Job description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Are you an experienced Medical Appeals Specialist in the Tacoma, WA area seeking a great career opportunity? Have you recently been seeking out prestigious, national healthcare companies with which to further your longterm goals? Are you seeking REAL advancement opportunities in-house with a Fortune 500 company? If you answered “yes” to any of these questions – then this opportunity may be for you!

Daily Responsibilities

In this role, you will be responsible for validating disputes presented on EOBs, entering denied claims into company database & escalating paymment/variance trends to management

Responsibilities

• Validate denial reasons and ensures coding in DCM is accurate and reflects the denial reasons
• Coordinates for clinical consultations or account referrals when necessary
• Generate an appeal based on the dispute reason and contract terms specific to payer
• Follow specific payer guidelines for appeals submission
• Escalate exhausted appeal efforts for resolution
• Review denial reasons on EOBs to determine denials
• Work payer projects as directed

Advantages of this Opportunity

• Competitive hourly pay above regional average!
• Longterm stability and individual professional growth potential from a national Healthcare company that continues to grow!
• You will have the opportunity to add great experience to your resume, while getting the chance to network with several future colleagues in a highly-competitive insurance claims field.

Qualifications

What We Look For

• 1-2 years in a healthcare administrative environment performing billing and/or collections
• 3-5 years of A/R follow up with insurance on claims (direct contract with insurancess)
• Full understanding of the insurance denials / appeals process
• Excellent computer skills with emphasis on use of Excel spreadsheets