Revenue Cycle Medical Billing Financial Appeal Writer BCBS

Revenue Cycle Medical Billing - Financial Appeal Writer - BCBS

Location: Remote or On-Site

Hourly Pay: $20

(this position is bonus eligible)

Work Schedule: Full-Time

The Financial Appeal Writer supports the functions of the Revenue Cycle Appeal team by assisting in the review of denied and underpaid claims for the formal appeal and dispute process with the payor. Responsibilities include, but are not limited to: classification of appeals, research of accounts, preparing documents, writing of appeal, appeal submission, obtaining appeal status, and review of appeal determinations.

Essential Functions/Duties

• Review Explanation of Benefits, denial letters and payor correspondence to classify type of appeal required.
• Gather, prepare, and review documentation & various forms needed to submit appeals correctly per payor guidelines.
• Write formal appeal using information and documentation specific to each account based on the denial type & appeal submission based on payor specific guidelines.
• Engage patients via phone and/or mail to obtain requested information pertaining to the appeal process.
• Document the details, requirements, and deadlines of each individual appeal in billing software.
• Manage daily workflow through report usage and ensure accounts are processed within required timeframes.
• Follow-up in a timely manner, regularly with payors regarding status of appeals.
• Identify payor issues within the appeal process and discuss potential improvements and workflow solutions with leadership.

Skills:

• Knowledge of health care billing procedures, reimbursement, third party payer regulations, documentation, and standards.
• Knowledge of Blue Cross Blue Shield and Commercial Insurance payors is a plus

• Understanding and interpretation of Explanation of Benefits (EOB) from payors
• Strong problem-solving skills, attention to detail, and ability to make timely decisions

• Excellent internal and external customer service skills
• Responsiveness and a strong commitment to meeting internal and external deadlines with limited supervision

Qualifications:

Required Experience

• Must be fluent in English
• Minimum of one (1) year of advanced medical billing experience
• Minimum of one (1) year experience with formal appeal writing and reconsideration processes for Commercial Insurances
• Knowledge and experience of computers and related technology
• Professional written and verbal communication skills

• Ability to work independently with little or no direction and as a member of a team

Preferred (Not Required) Experience

• Minimum of one (1) year working in a call center environment
• Above average knowledge of insurance billing guidelines and policies

Preferred Education:

• High School diploma
• GED
• Or significant relevant work experience