Appeal Writer - RN Job at Med-Metrix in Village of Garden City

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Overview

The Licensed Appeal Writer supports the Company by reviewing insurance claims denied for payment on behalf of our client hospitals. Working closely with nurses and other team members, the Licensed Appeal Writer creates appeal letters in support.

Duties & Responsibilities

• Review denied insurance claims
• Review patients’ medical files
• Develop strategies to reverse claim denials
• Create written appeals
• Manage and organize appeal workflow based on internal, client-based, and insurance-driven deadlines
• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
• Understand and comply with Information Security and HIPAA policies and procedures at all times
• Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties

Qualifications

Working Conditions

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

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