SENIOR APPEALS/DENIALS ANALYST

ERISA Recovery; Plano (TX); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

401(k) matching

Health insurance

Vision insurance

Health savings account

Flexible spending account

Life insurance

Disability insurance

Paid holidays

Lunch program

Signing bonus

Referral bonus

Monthly bonus

Quarterly bonus

Vacation time

Sick time

Gym access

Job summary

ERISA Recovery, Inc. in Plano, TX is seeking a Senior Medical Hospital Appeal/Denial specialist. This role focuses on reviewing denied hospital claims, drafting appeals, and maximizing recoveries across UB-04 processes.

You will work in-office, multitask in a fast-paced team, collaborate with insurance companies and providers, and contribute to a growing revenue cycle operation with strong bonus programs and benefits.

Qualifications

• 5-10 years of experience with collecting hospital medical bills and writing appeals (ERISA experience a plus).
• Proficient in computer skills including Windows PC applications, typing, navigation and willingness to learn new systems/programs.
• Ability to communicate effectively with excellent verbal and written communication skills.
• Ability to multi-task complex cases while remaining productive and focused daily.
• Excellent organizational skills with focus on detail.

Responsibilities

• Review independently, submit/follow up, document and collect billing on denied hospital medical claims.
• Resolve denied hospital medical claims quickly and accurately.
• Write medical appeals using clear language to maximize recoveries.
• Communicate with insurance companies and healthcare providers.
• Collaborate with internal and external departments to resolve claims.

Skills

Hospital billing

Appeals writing

UB-04 claims processing

Communication

Multi-tasking

Tools

Windows PC applications

Job description

Top applicants with vast knowledge of hospitals claim denials wanted!

ERISA Recovery are experts in collecting complex and aged claims through the Federal ERISA appeals process. We are a fast-growing organization located in Plano, TX. Our collaborative and innovative team offers an extraordinary opportunity for career growth in the ever-evolving revenue cycle industry.

We are looking for a Senior Medical Hospital Appeal/Denial specialist who is a master at multitasking, team-driven, focused, thrives in a fast-paced environment, thinks outside the box and able to work independently.

Candidates with an in-depth knowledge of hospital medical billing, collections, writing appeals and the reimbursement claims process should apply.

Essential responsibilities and duties

• Current background with UB-04 claims processing with an In-depth understanding of hospital billing form requirements (UB-04)
• Knowledge of medical terminology, CPT codes, modifiers, and diagnosis codes
• Complete understanding of the revenue cycle process to include prior authorization, billing, insurance appeals, and hospital collections
• Understanding of payor contracts
• Independently, review, submit/follow up, document and collect billing on denied hospital medical claims
• Resolve denied hospital medical claims in a quick and accurate time frame
• Effectively communicate and correspond with insurance companies and healthcare providers
• Write medical appeals using clear and simple language to optimize the recovery of denied claims
• Effectively communicate and collaborate with internal and external departments to resolve claims
• Ability to navigate multiple computer programs and platforms
• Be willing to learn and leverage new systems/programs and training resources to apply to the claims process
• Meet the daily and monthly performance goals

Desired skills and Qualifications

• 5-10 years of experience with collecting hospital medical bills and writing appeals (ERISA experience a plus)
• Proficient in computer skills including Windows PC applications, typing, navigation and willingness to learn new computer systems/programs
• Ability to communicate effectively with excellent verbal and written communication skills
• Ability to multi-task complex cases while remaining productive and focused on a daily basis
• Excellent organizational skills with focus on attention to detail
• Provide outstanding professional customer service to clients, team members and external stakeholders
• Successful completion of new hire process and continual training
• Desire to be productive in a fast-paced environment while maintaining a positive atmosphere
• 401(k), matching
• Health insurance
• Vision insurance
• Health savings account
• Flexible spending account
• Life insurance
• Disability insurance
• Paid holidays
• Lunch program
• Bonus programs-signing bonus, referral bonus, monthly and quarterly bonus
• Vacation and sick time
• Free Gym access

Full time

In-office only

ERISA Recovery is an Equal Opportunity Employer