Appeals and Denials Representative – Workers Compensation

Posted Yesterday
Be an Early Applicant
The Woodlands, TX, USA
In-Office
12-15 Hourly
Junior
Healthtech
The Role
Review workers' compensation claim referrals, prepare and submit initial bills and reconsiderations, request necessary documentation, monitor claim/reconsideration status, post payments in account software, and report denial trends to supervisors.
Summary Generated by Built In
Company Description

Alegis/ MedData is among the nation’s leading providers of medical billing services. For over 3​5 years, MedData has solidified its leadership position within the billing sector by expanding upon and redefining the typical revenue cycle management processes of coding, billing, and collections. 

MedData serves ​5,000 physicians across a growing network of 1,000+ facilities throughout the U.S., having built a national presence by becoming experts at the state level. To date, we have handled billing for more than ​200 million patients. 

Job Description

Alegis seeks an Appeals and Denials Representative with knowledge on the billing and the reconsideration process for the Workers Compensation payers. Responsibilities will include but are not limited to:

•Review of new claim referrals; for initial billing; billing follow-up; or preliminary determination whether denial can be overturned with a reconsideration;   

•Request of any necessary documentation needed in order to initially bill claims; prepare reconsideration;

•Prepare and submit initial bill or reconsideration to the Workers Compensation payer;

•Monitor accounts for updates on claim/reconsideration status;

•Post Workers Compensation payments in Account Management software;

•Inform supervisor of trends noticed when working denials.

$12-15 per hour, Mon-Fri

Qualifications

• A minimum of a high school diploma;

• Strong computer skills including Microsoft Excel, and Word;

• Able to communicate (both written and verbal) in a professional manner;

• Ability to multi-task and work with minimal supervision;

• Required to have at least one year of experience in hospital billing or appealing Workers Compensation denials;

• Requires exceptional attention to detail and demonstrated ability to prioritize work to ensure accuracy and timely completion of assigned work;

• Requires investigational and analytical skills;

• Knowledge of Workers Compensation regulations and billing practices; government payers including Medicare and Medicaid a plus;

• Knowledge in hospital and insurance reimbursement and billing concepts and procedures, as well as laws and regulations affecting payment compliance, denials and appeals recovery;

Additional Information

All your information will be kept confidential according to EEO guidelines.  

This is a Hourly, Non-Exempt position. We offer an exceptional benefits package which includes Medical, Dental, Vision, Life Insurance, Short and Long Term disability as well as a 401K plan. 

MedData  provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws.

Pay is commensurate with experience + Benefits, Sick & Vacation time, and paid holidays

Skills Required

  • High school diploma or equivalent
  • Minimum one year experience in hospital billing or appealing Workers Compensation denials
  • Knowledge of Workers Compensation regulations and billing practices
  • Knowledge of hospital and insurance reimbursement, billing concepts, payment compliance, denials and appeals recovery
  • Strong computer skills including Microsoft Excel and Microsoft Word
  • Professional written and verbal communication skills
  • Ability to multi-task and work with minimal supervision
  • Exceptional attention to detail and ability to prioritize work for accuracy and timeliness
  • Investigational and analytical skills
  • Knowledge of government payers including Medicare and Medicaid
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The Company
HQ: The Woodlands, TX
807 Employees
Year Founded: 1980

What We Do

MedData is a leading provider of technology-enabled revenue cycle management services designed to engage patients, empower hospitals and health systems, and improve financial outcomes throughout the entire healthcare continuum. For four decades, MedData has proudly partnered with care providers at thousands of facilities nationwide to serve millions of patients onsite, in the field, and from our regional offices across the U.S. Our core services include Eligibility & Disability, Injury Accounts (Workers' Comp and Liability), Out-of-State Eligibility, Patient Responsibility/Early Out, Denials Management, and Veterans Administration.

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