TAL Healthcare
West Hempstead, NY, USA
Job Description Our client, a national company servicing medical across the county and NY is seeking a Medical Billing and Follow-up Specialist. Responsibilities: Creates and manages submission, intervention and resolution of bills, appeals, and grievances both electronically and manually Conducts pertinent research, evaluates, responds and completes appeals and other insurance/policy guideline inquiries accurately, timely and in accordance with all established regulatory guidelines. Prepares appeal documentation, summaries, correspondence, as well as documents information for tracking/trending data. Review denied insurance claims, identify and resolve the issues in order to resubmit. Develop strategies to reverse claim denials. Manage and organize appeal workflow based on internal and insurance-driven deadlines. Researches insurance policy language to determine medical necessity criteria. Request and obtain medical records, notes, and/or detailed...