Appeals Specialist

Position Overview 

OrthoMed Anesthesia seeking a detail-oriented Appeals Specialist to join our fast-growing organization in Addison, TX. The ideal candidate will be responsible for managing and processing insurance claim appeals, ensuring maximum reimbursement for our services. This is a full-time position based at our corporate office in Addison, TX. The role requires on-site presence during regular business hours. 

Key Responsibilities 

• Review denied claims and determine appropriate appeal strategies 

• Prepare and submit appeal letters with supporting documentation 

• Follow up on pending appeals and track their progress 

• Communicate with insurance companies, healthcare providers, and patients regarding appeal status 

• Maintain accurate records of all appeal activities 

• Analyze appeal outcomes and identify trends to improve the appeals process 

• Stay updated on insurance policies, regulations, and appeal procedures 

Qualifications 

• Bachelor's degree in Healthcare Administration, Business, or related field (or equivalent experience) 

• 2+ years of experience in medical billing, claims processing, or appeals management, preferably in anesthesia or a related specialty 

• Strong knowledge of medical terminology, CPT, and ICD-10 coding 

• Familiarity with insurance policies, Medicare, and Medicaid regulations 

• Excellent written and verbal communication skills 

• Strong analytical and problem-solving abilities 

• Proficiency in Microsoft Office suite and medical billing software 

At OrthoMed, you'll be part of a team dedicated to excellence in patient care. We offer competitive compensation, health/dental/vision insurance, company paid life insurance, 401(k) with 3% non-discretionary company contributions, professional development opportunities, and a fun collaborative work environment. 

Join us in our mission to elevate healthcare standards and make a lasting impact. Apply now to become an integral part of our dynamic team!