Strategic Medical Appeals Specialist

PHI Health, LLC; Phoenix (AZ); On-site; USD 55,000 - 85,000; Full time

Benefits offered by this job

Sign-on bonus

Job summary

PHI Health, LLC in Phoenix, AZ seeks an Appeals Negotiator to maximize reimbursement from underpayments and manage payer relationships. You will document underpayments, support payments with documentation, and resolve denials per regulations.

Requirements include 5+ years in medical billing/appeals, Medicare/Managed Care experience, and the ability to draft persuasive appeal letters. A sign-on bonus up to $7,500 is offered.

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, EMS billing and collections.
• Medicare, Managed Care, Workers' Comp experience.
• 3-5 years in appeals and negotiation.
• Expertise in billing software and Internet-based research.
• Ability to draft professional appeal letters and research regulatory docs.
• Strong written and verbal communication; independent work capability.

Responsibilities

• Ensure highest reimbursement for underpaid payers.
• Build and maintain payer relationships per policies.
• Identify and document underpayments from payers.
• Provide thorough supporting documentation for payments.

Skills

Medical billing

Negotiation

Communication

Education

Bachelor's degree preferred

Tools

Billing software

Internet research

Job description

PHI Health, LLC in Phoenix, AZ seeks an Appeals Negotiator to maximize reimbursement from underpayments and manage payer relationships. You will document underpayments, support payments with documentation, and resolve denials per regulations.

Requirements include 5+ years in medical billing/appeals, Medicare/Managed Care experience, and the ability to draft persuasive appeal letters. A sign-on bonus up to $7,500 is offered.