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medmix · 1 week ago

Licensed Appeal Writer

Garden City, NY, USA

Full-time

Onsite

Mid Level

$75K/yr - $75K/yr

medmix is seeking a Licensed Appeal Writer to support the company by reviewing denied insurance claims on behalf of client hospitals. The role involves creating appeal letters, managing appeal workflows, and ensuring compliance with HIPAA standards.

Health CareManufacturingMedicalMedical Device

Responsibilities

Review denied insurance claims

Review patients’ medical files

Develop strategies to reverse claim denials

Create written appeals

Manage and organize appeal workflow based on internal, client-based, and insurance-driven deadlines

Other duties as assigned

Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

Understand and comply with Information Security and HIPAA policies and procedures at all times

Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties

Qualification

Active professional licenseAnalytical skillsMedical terminology analysisMicrosoft Office SuiteCommunication skillsTech-savvyCustomer service skillsProblem solving skillsInterpersonal skillsDocumentation skills

Required

4-year degree or work equivalency required

Must hold an active license as a Physician's Assistant (PA), Registered Nurse (RN), Nurse Practitioner (NP), Licensed Practical Nurse (LPN), Physical Therapist (PT), Occupational Therapist (OT), or an equivalent professional license

Strong analytical, communication, and documentation skills are essential

Must be able to prioritize workload based on strict deadlines

Must be tech-savvy with ability to quickly learn new software

Must possess a high level of reading comprehension and ability to analyze medical information and terminology

Proficiency in Microsoft Office Suite

Strong interpersonal skills, ability to communicate well at all levels of the organization

Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses

High level of integrity and dependability with a strong sense of urgency and results oriented

Excellent written and verbal communication skills required

Gracious and welcoming personality for customer service interaction

Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes