Appeals Specialist

Posted 2 Days Ago
Be an Early Applicant
Hiring Remotely in GA, USA
Remote
Mid level
Cloud • Insurance • Financial Services
The Role
The Appeals Specialist will process insurance claims, handle follow-ups, maintain account information, and support billing and collections efforts.
Summary Generated by Built In
Medical Data Systems Inc. is seeking a detail-oriented and motivated Insurance Specialist to join our insurance support and billing team. The ideal candidate will demonstrate professionalism, independence, and a strong understanding of insurance processes while thriving in a fast-paced environment.
Key Responsibilities
  • Perform insurance follow-up activities, including claim submission, claim status inquiries, and filing appeals for denied claims.
  • Process a high volume of detailed account information accurately and within established performance guidelines.
  • Navigate multiple systems to obtain insurance, contact, and attorney information as needed.
  • Support the prioritization of collections efforts by accurately updating account data and identifying next steps.
  • Maintain the highest level of confidentiality and adhere to all HIPAA regulations.
  • Apply hospital billing knowledge to carry out assigned duties efficiently.
Essential Duties
  • Complete insurance-related tasks such as correcting and resubmitting claims, filing appeals, and contacting insurance companies, attorneys, or patients regarding outstanding balances.
  • Work assigned facility-specific queues, ensuring all accounts are updated with correct and complete information.
  • Participate in special projects or assignments as directed.
  • Assist colleagues and management by providing information or support related to insurance processes when needed.
Qualifications
  • 3-5 years of experience in a healthcare setting such as a hospital business office, surgery center, physician practice, or health insurance organization.
  • Strong communication skills, attention to detail, and self-motivation.
  • Proficient knowledge of insurance processes, including claim submission, claim denials, HCPCS/CPT/ICD-10 coding basics, and claim status inquiries.
  • Familiarity with Medicare/Medicaid, Commercial, Auto, Workers’ Compensation, Liability, Crime Victims, and State/Federal Insurance Programs.
  • Experience with medical billing and collection practices, business office procedures, and multi-system computer navigation.
  • Ability to type at least 55 words per minute.
  • High School Diploma or GED required; some college preferred.
Position Details
  • Employment Type: Full-Time

Skills Required

  • 3-5 years of experience in a healthcare setting
  • Strong communication skills
  • Proficient knowledge of insurance processes
  • Ability to type at least 55 words per minute
  • High School Diploma or GED
Am I A Good Fit?
beta
Get Personalized Job Insights.
Our AI-powered fit analysis compares your resume with a job listing so you know if your skills & experience align.

The Company
HQ: Vero Beach, Florida
124 Employees
Year Founded: 1985

What We Do

MDS is a privately held company, founded in 1985, incorporated in 1988 by two individual owners, and is exclusively healthcare focused. MDS services 600+ individual facilities nationwide. Our skills, experience, high ethical standards, and history of success have earned MDS a reputation as the industry’s preferred accounts receivable partner. MDS proudly offers: o Extended Business Office / Early Out Services  Self-Pay Recovery  Insurance Recovery & Claims Resolution o Self-Pay Bad Debt Collections o Systems Conversion Projects MDS combines a team of seasoned collection professionals with state-of-the-art technology to offer our Clients efficient and effective recovery services. Licensed to collect in all 50 states, all accounts are serviced in a compliant, legal and ethical manner. MDS’ proprietary systems provide exceptional flexibility to integrate with all forms of hospital patient accounting systems. Combining artificial intelligence with multiple layers of robotic process automation, we minimize decision-making, allowing recovery specialists to focus on more complex recovery opportunities. MDS offers many convenient options for payment, including online tools, mobile apps and QR codes on patient friendly statements. Proven Leader • Unique approach to insurance identification, resulting in greater collections • All accounts pursued, regardless of account balance • Successful collections without patient complaints • Extensive reports suite provides relevant, timely information • Automated processes and increased efficiencies utilizing the latest AI technology. • Solution-oriented collection approach for rapid account resolution and patient retention. • Automated and personalized assurance that payment plans have the follow-up and results you expect

Similar Jobs

PwC Logo PwC

Data Scientist

Artificial Intelligence • Professional Services • Business Intelligence • Consulting • Cybersecurity • Generative AI
Remote or Hybrid
60 Locations
370000 Employees
77K-202K Annually

PwC Logo PwC

Data Scientist

Artificial Intelligence • Professional Services • Business Intelligence • Consulting • Cybersecurity • Generative AI
Remote or Hybrid
62 Locations
370000 Employees
99K-232K Annually
Remote or Hybrid
United States
1750 Employees

Trail of Bits Logo Trail of Bits

Senior Security Engineer

Artificial Intelligence • Blockchain • Professional Services • Security • Consulting • Cybersecurity • Defense
Remote
United States
125 Employees
100K-220K Annually

Similar Companies Hiring

Granted Thumbnail
Mobile • Insurance • Healthtech • Financial Services • Artificial Intelligence
New York, New York
23 Employees
Hanover Park Thumbnail
Artificial Intelligence • Fintech • Software • Financial Services
New York, New York
31 Employees
Onshore Thumbnail
Artificial Intelligence • Fintech • Software • Financial Services
New York, New York
60 Employees

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account