Aging and Billing Resolution Specialist

We are an all-inclusive, full service, behavioral health billing company and we are seeking an experienced Appeals Specialist to join our team.
Primary Job Responsibilities: Research and document denials in a thorough, professional and expedient manner Analyze denied claim explanation of benefits, insurance carrier contacts, and general correspondence from insurance companies Request medical records from internal staff when needed Compose all correspondence in accordance with regulatory requirements, to reflect accurate appeal information in a clear, concise, grammatically correct format Maintain tracking system of correspondence and outcomes for appeals Maintain well-organized, accurate and complete files for all appeals Monitor each appeal to ensure all internal and regulatory timelines are met Act as point of contact for submission and/or resolution of denial determinations and interfaces with insurance companies in regards to reconsiderations, disputes and/or appeals Responsible for data collection and analysis regarding specific denial determinations and appeals Develop necessary policies and procedures and oversees quality assurance measures related to appeals Review denied claims looking for large trend issues