Insurance Appeals Specialist

Job type:Contract
Salary/Rate:$25 - $30 per hour
Business Sector:Accounting/Finance
Job ref:JF338118523
Post Date:May 23, 2024
Lighthouse Professional Services a division of Staffing 360 Solutions group, is proud to be a “Best in Staffing 2023” award winner. We have over 50 years of experience placing people with small and global companies. Our offices in New York, Connecticut, and Massachusetts serve clients nationwide. 
We are currently seeking an Insurance Appeals Specialist for a client in Suffern, NY (HYBRID).

Duration: 3-6-Month Contract (benefits eligible)
Location: Suffern, NY Hybrid (on-site initially for training)
Pay Rate: $23-$27/hour depending on experience
Job Summary:
Seeking an experienced Appeals Specialist, playing a pivotal role in our Accounts Receivable Dept. The ideal candidate will conduct thorough reviews of denials and appropriately work denials with medical records and/or appeals via set protocols in a timely and professional manner.

  • Compose and submit all required documentation (including appropriate medical records to support medical necessity) for a reconsideration or appeal  to an insurance carrier via payer portal fax or mail.
  • Utilize appropriate applications to accurately track appeals to include tracking of success rates.
  • Gather and fill out any payer specific forms and letters.
  • Effectively manage and work to maintain timely responses to denials within specific deadlines.
  • Establish tracking mechanism for appropriate follow-up on appeals submitted.
  • Knowledge of medical terminology, CPT, ICD10 and procedural modifiers
  • Proficient with Excel, Word and Outlook
  • Strong organization and time management skills. 
  • Ability to communicate effectively in writing, over the telephone, and in-person while always remaining HIPAA compliant
Education and Experience:
  • High school diploma (college degree a plus)
  • Two years of experience in medical billing with a healthcare facility or billing company
  • Two years of experience working appeals for healthcare preferably in the lab space but not required. 

Qualified candidates are encouraged to apply immediately!
Please include a clean copy of your resume, salary expectations and any references.