Medical Appeals Negotiator - Billing & Denials Pro

PHI Air Medical, LLC; Phoenix (AZ); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Sign-on bonus up to $7,500

Job summary

PHI Health is seeking an Appeals Negotiator to maximize reimbursements for underpaid payers and manage payer relationships. The role requires documenting underpayments, providing supporting documentation for additional payments, and resolving denials with strong regulatory knowledge.

The candidate should have 5+ years in medical billing/collections, experience with Medicare/Managed Care, and exceptional written and verbal communication.

Qualifications

• High School diploma or GED required.
• Bachelor’s degree preferred with 5 years related work experience.
• 5+ years’ experience in medical billing, surgical billing, billing in EMS and collections preferred.
• Medicare, Managed Care, Workers’ Comp. experience.
• 3-5 years of experience in appeals and negotiation background.
• Expertise in billing software and Internet-based research required.
• Solid knowledge of patient account systems and revenue management processes.
• Ability to work independently with strong interpersonal skills.
• Ability to draft professional appeal letters and communicate clearly.
• Understanding of regulatory documents and compliance.

Responsibilities

• Ensure the highest reimbursement for underpaid payers and maintain payer relationships.
• Identify, document, and assist in collecting underpayments from payers.
• Provide thorough supporting documentation for additional payments.
• Oversee and resolve denials requiring written response, including medical necessity and usual payments.
• Comply with federal and state regulations and clinical record information extraction.
• Report to leadership of Patient Financial Services.

Skills

Interpersonal skills

Strong written communication

Regulatory knowledge

Attention to detail

Negotiation experience

Analytical reasoning

Independent work

Education

High school diploma or GED

Bachelor’s degree preferred

Tools

Billing software

Internet research

Patient accounting systems

Job description

PHI Health is seeking an Appeals Negotiator to maximize reimbursements for underpaid payers and manage payer relationships. The role requires documenting underpayments, providing supporting documentation for additional payments, and resolving denials with strong regulatory knowledge.

The candidate should have 5+ years in medical billing/collections, experience with Medicare/Managed Care, and exceptional written and verbal communication.