medical appeals specialist.

Randstad is seeking a detail-oriented and tenacious Medical Billing Appeals Specialist to play a vital role in our revenue cycle management. The ideal candidate will be responsible for reviewing denied claims, determining the appropriate course of action based on payer requirements, and diligently pursuing successful claim appeals. This position requires a good understanding of medical billing processes, payer regulations, and excellent organizational and communication skills. If you are interested in this role please apply and send your resume to zac.rawson@randstadusa.com

salary: $17.28 - $18.28 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School

Responsibilities

• Denial Analysis and Action: The core of the role involves understanding why claims are denied and knowing what steps to take based on each payer's specific rules.
• Appeal Preparation: This includes gathering all the necessary paperwork and organizing it within the billing system to formally dispute the denied claim.
• Documentation Management: Ensuring that the correct documentation is sent to the insurance company according to their guidelines is crucial for a successful appeal.
• Payer Knowledge: Staying up-to-date on the ever-changing requirements of different insurance carriers is essential for effective appeals.
• System Proficiency: Navigating and utilizing claim appeal billing systems efficiently is a key part of the daily workflow.
• Error Identification and Reporting: This proactive aspect helps prevent future denials by highlighting systemic issues in the billing process.
• Flexibility and Adaptability: The role also requires the ability to handle various ad-hoc tasks as needed.

Skills

Medical Billing (1 year of experience is required)

ICD-10

CPT Codes

Claims Processing

Medicare Compliance

Analytical Thinking

Documentation of Operations

Payer Requirements

Qualifications

Years of experience: 1 year

Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.