Insurance Verification and Appeals Specialist

📋 Description

• Verify DME policy inclusions/exclusions via payer portals
• Calculate patient responsibility (deductibles vs coinsurance)
• Initiate Pre-Service Appeal or Peer-to-Peer when denied
• Coordinate referrals between PCP and prescribing HCP
• Identify missing clinical notes and coordinate with doctors
• Document interactions in CRM per HIPAA/QA guidelines

🎯 Requirements

• Bachelor's degree strongly preferred; high school diploma or equivalent required
• Minimum 3 years in healthcare with Medicare Part B/Medicare Advantage and Commercial payors
• Strong organizational skills with attention to detail
• Computer skills: MS Office, Google, Internet, and CRM systems
• Ability to prioritize tasks and manage time effectively in a fast-paced environment
• Excellent written and verbal communication skills

🎁 Benefits

• Remote position
• Robust benefits package