Vacancy Description
Responsibilities
- Review denied claims and assess appeal potential
- Prepare and submit documented appeals for laboratory services
- Communicate with providers and insurance representatives for supporting records
- Track appeals, follow up on resolution, and maintain billing system records
- Analyze denial trends and recommend process improvements
- Apply payor policies, coding guidelines, and healthcare regulations
- Collaborate with clinical, market access, and insurance teams
Requirements
- 3-5 years of laboratory billing appeals experience
- Strong understanding of insurance policies and payor processes
- Knowledge of healthcare regulations, medical terminology, and coding
- Experience with major insurance plans, Medicaid, and Managed Medicaid
- Familiarity with HIPAA compliance
- Proficiency in Microsoft Office Suite
- Xifin experience preferred
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