Appeals Specialist

Position Overview

OrthoMed Anesthesia seeking a detail-oriented Appeals Specialist to join our fast-growing organization in Addison, TX. The ideal candidate will be responsible for managing and processing insurance claim appeals, ensuring maximum reimbursement for our services. This is a full-time position based at our corporate office in Addison, TX. The role requires on-site presence during regular business hours.

Key Responsibilities

• Review denied claims and determine appropriate appeal strategies

• Prepare and submit appeal letters with supporting documentation

• Follow up on pending appeals and track their progress

• Communicate with insurance companies, healthcare providers, and patients regarding appeal status

• Maintain accurate records of all appeal activities

• Analyze appeal outcomes and identify trends to improve the appeals process

• Stay updated on insurance policies, regulations, and appeal procedures

Qualifications

• Bachelor's degree in Healthcare Administration, Business, or related field (or equivalent experience)

• 2+ years of experience in medical billing, claims processing, or appeals management, preferably in anesthesia or a related specialty

• Strong knowledge of medical terminology, CPT, and ICD-10 coding

• Familiarity with insurance policies, Medicare, and Medicaid regulations

• Excellent written and verbal communication skills

• Strong analytical and problem-solving abilities

• Proficiency in Microsoft Office suite and medical billing software

At OrthoMed, you'll be part of a team dedicated to excellence in patient care. We offer competitive compensation, health/dental/vision insurance, company paid life insurance, 401(k) with 3% non-discretionary company contributions, professional development opportunities, and a fun collaborative work environment.

Join us in our mission to elevate healthcare standards and make a lasting impact. Apply now to become an integral part of our dynamic team!