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Senior Appeals Representative

Company: VirtualVocations
Location: Lafayette
Posted on: June 6, 2024

Job Description:

A company is looking for a Senior Appeals Representative for a national remote position.

Key Responsibilities:

Review and interpret provider and health plan contracts to ensure accurate payment of claims
Adjust claims, utilize claims platform application for reprocessing, and identify system issues affecting claims processing
Communicate with providers, document disputes accurately, and maintain department standards for appeals

Required Qualifications:

High School Diploma/GED
2+ years of experience as a Claims Examiner and/or appeals representative
Extensive knowledge of medical coding, UB04, CMS 1500 forms, and HMO guidelines
Proficiency in Microsoft Excel and Access
Ability to work full-time within specified business hours

Keywords: VirtualVocations, Lafayette , Senior Appeals Representative, Other , Lafayette, Louisiana

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