Appeals Specialist I

ROMTech is a medical technology company that has created and patented a revolutionary medical device and telemedical platform which delivers in-home rehabilitative care. Our disruptive technology has proven to yield faster recoveries and better outcomes with unmatched patient compliance. We began in orthopedics and have entered scale-up of our orthopedic business. We are now leveraging our core technology, infrastructure, and first mover position to enter cardiology, followed by other adjacent markets. Having created this new lane, we have a unique opportunity to serve as the global leader in the business, technology, and science of recovery, and to bring life-changing help to many millions of people.

Job Summary 

The Appeals Specialist is critical to ensuring accurate and timely resolution of insurance claims and appeals for our medical devices, contributing directly to our financial health and patient satisfaction.

Key Responsibilities

•    Review and analyze denied insurance claims to determine appropriate appeal strategies.
•    Prepare and submit appeals to insurance providers, ensuring compliance with payer guidelines and timelines.
•    Collaborate with billing, coding, and clinical teams to gather necessary documentation for appeals.
•    Monitor appeal outcomes and follow-up on unresolved cases. 
•    Maintain accurate records of all claims and appeals activity in the system.
•    Performs other related duties as required or requested.to our financial health and patient satisfaction.

Skills & Abilities

• Excellent written and verbal communication skills.
• Ability to work independently and manage multiple priorities in a fast-paced environment.

Work Experience Requirements

• Proven experience in medical billing, claims processing, or revenue cycle management, preferably in a medical device or healthcare setting.

• Deep understanding of insurance guidelines, EOBs, and appeal processes.

Physical Demands and Working Conditions 
•    Ability to sit at a computer terminal for an extended period.
•    Moderate noise (i.e., phone calls, online meetings, computer audio)
•    While performing the duties of this job, the employee may be regularly required to stand, sit, talk, hear, reach, stoop, kneel, and use hands and fingers to operate a computer, telephone, and keyboard.
•    Specific vision abilities required by this job include close vision requirements due to computer work.
•    Regular, predictable attendance is required.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Reasonable accommodation requests must be made in writing by emailing [email protected].