Prosthetic and Orthotic Appeal Specialist

Job Description

Job DescriptionSalary:

Are you ready to take your career to the next level in a fast-paced, dynamic company? Were looking for a detail-oriented prosthetic and orthotics appeal specialist to join our growing team!

As an appeals specialist, youll play a crucial role in the revenue cycleensuring accurate and timely submission of appeals. Your knack for organization, love for policy, patient care, and commitment to precision will directly impact our operational success and client satisfaction.

Summary: Performs insurance appeal services for multiple accounts effectively and efficiently. Performs billing services for one or more accounts effectively and efficiently. This role works directly under the Chief Operating Officer.

Primary Duties:

1. Submit appeals for assigned clients within 30 days of Submit to AD date on the Appeals Tracker
2. Follow up on all appeals for assigned clients within 48 hours of follow up date date on Appeals Tracker
3. Learn and become proficient in all versions of software utilized by assigned accounts
4. Efficiently complete authorization appeals
5. Efficiently complete appeals, reconsiderations, and ALJ submissions, and appeal follow-up
6. Documentation of all work performed in multiple versions of patient billing software
7. Answering routine incoming calls
8. Understand and comply with all policies and procedures in the Company handbook

Secondary Duties:

1. Attends Continuing Education Seminars either in person or via webinar per the Leadership Teams request
2. Attend and represent the Company at national and local trade shows per the Leadership Teams request
3. Other tasks as assigned by management

Required Knowledge and Skills:

1. Proficiency in the following tasks:
   1. Appeal review, compilation, and submission
2. Must be able to efficiently perform written and oral communications with co-workers and insurance representatives.
3. Must be able to proficiently utilize the following computer programs:
   1. Microsoft Office including Excel, Outlook, Teams, Word
   2. TimeDoctor;
   3. VoIP System
   4. Web Browsers
4. Must be able to read, understand and analyze general business periodicals, professional journals, procedure manuals, or governmental regulations.

remote work