Insurance Claims & Appeals Specialist

Heritage Medical Associates, P.C.; Nashville (TN); On-site; USD 42,000 - 62,000; Full time

Job summary

Heritage Medical Associates, P.C. in Nashville, TN is seeking an Insurance Analyst to manage denied and pending insurance claims, submit appeals, and maintain billing queues.

The role emphasizes excellent customer service to patients and staff, with responsibility for answering questions about insurance benefits and balances. The position requires 3–5 years of third‑party physician billing, ICD-10/CPT coding knowledge, and experience with medical billing systems, ensuring compliance and accuracy

Qualifications

• High school diploma required; 3–5 years of third-party billing in a physician's office.
• Knowledge of ICD-10/CPT coding.
• Experience in medical billing systems.
• Thorough understanding of Medicare/Medicaid laws, managed care, and commercial health insurance.
• Strong customer service and communication skills.
• Excellent telephone etiquette.

Responsibilities

• Work denied claims through the practice management queue.
• Process denials in a timely and accurate manner.
• Create and submission of appeals.
• Communicate with insurance companies as needed.
• Query provider in a timely manner as needed.
• Interpret and apply compliance guidelines to maintain billing integrity.
• Audit accounts referred by Patient Service Representatives and Patient Accounts.
• Post corrected claims and any payments associated with that correction.
• Transfer credits in an account.
• Apply self-pay discounts, charity and per request adjustments.
• Verify balances and refunds for accuracy; ensure timely follow up with patient.
• Follow HMA guidelines in applying self-pay discounts and adjustments.

Skills

Strong Customer Service

Telephone etiquette

Written and verbal communication

Supervision independence

Organizational skills

Self motivated

Team collaboration

Attendance

Education

High school diploma

Job description

Heritage Medical Associates, P.C. in Nashville, TN is seeking an Insurance Analyst to manage denied and pending insurance claims, submit appeals, and maintain billing queues.

The role emphasizes excellent customer service to patients and staff, with responsibility for answering questions about insurance benefits and balances. The position requires 3–5 years of third‑party physician billing, ICD-10/CPT coding knowledge, and experience with medical billing systems, ensuring compliance and accuracy