Medical Biller Account Representative

Alegis, A MedData Company; Austin (TX); On-site; USD 17,908 - 20,664; Full time

Benefits offered by this job

Health, Vision, and Dental Benefits

Floating Holiday(s) and PTO

7 paid holidays

Job summary

Alegis, A MedData Company in Austin, Texas is seeking an Appeals and Denials Representative to handle the appeal process for government plans and managed care insurance. The role involves reviewing denial referrals, preparing appeals, and submitting them to insurance carriers.

The ideal candidate should have a high school diploma, strong computer skills, and at least one year of relevant experience. The position offers hourly pay between $13.00 and $15.00 based on experience, along with health benefits and paid holidays.

Qualifications

• Minimum of one year of experience in a collection insurance or related healthcare environment.
• Requires exceptional attention to detail and ability to prioritize work.
• Knowledge in hospital and insurance reimbursement, billing concepts, and laws affecting payment compliance.

Responsibilities

• Review denial referrals to identify root causes of denial.
• Request documentation needed for preparing appeals.
• Prepare and submit appeals to insurance carriers.
• Monitor accounts for updates on claim and appeal status.
• Post insurance payments in Account Management software.
• Inform supervisor of trends in working denials.

Skills

Strong computer skills including Microsoft Excel and Word

Ability to communicate in a professional manner

Attention to detail

Investigational and analytical skills

Knowledge of managed care industry and government payers

Education

High school diploma

Job description

MedData is among the nation’s leading providers of medical billing services. For over 35 years, MedData has solidified its leadership position within the billing sector by expanding upon and redefining the typical revenue cycle management processes of coding, billing, and collections.

MedData serves 5,000 physicians across a growing network of 1,000+ facilities throughout the U.S., having built a national presence by becoming experts at the state level. To date, we have handled billing for more than 200 million patients.

Job Description

Alegis seeks an Appeals and Denials Representative with knowledge on appeal process for government plans and managed care insurance. Pay is commensurate with experience and range from $13.00 - $15.00 per hour.

Responsibilities will include but are not limited to:

• Review of denial referrals; for early identification of root cause of denial; preliminary determination whether denial can be overturned;
• Request of any necessary documentation needed in order to prepare appeals;
• Prepare and submit appeals to insurance carriers;
• Monitor accounts for updates on claim/appeal status;
• Post insurance payments in Account Management software;
• Inform supervisor of trends noticed when working denials.

Qualifications

• A minimum of a high school diploma;
• Strong computer skills including Microsoft Excel, and Word;
• Able to communicate (both written and verbal) in a professional manner;
• Ability to multi-task and work with minimal supervision;
• Required to have at least one year of experience in a collection insurance, or related healthcare environment;
• Requires exceptional attention to detail and demonstrated ability to prioritize work to ensure accuracy and timely completion of assigned work;
• Requires investigational and analytical skills;
• Knowledge of managed care industry and government payers including Medicaid;
• Knowledge in hospital and insurance reimbursement and billing concepts and procedures, as well as laws and regulations affecting payment compliance, denials and appeals recovery;

Additional Information

Pay and Benefits

$13-$15 hourly (depending on experience with hospital billing)

Health, Vision and Dental Benefits

Floating Holiday(s) and PTO

7 paid holidays

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an Employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the Employee is frequently required to sit; use hands or fingers to handle, or feel; and react with hands and arms. The Employee is occasionally required to stand and walk and must occasionally lift and/or move up to 50 pounds.

Occasional travel is required.

MedData is an Equal Opportunity Employer