US Eye Accounts Receivable (AR) Appeals Specialist

US Eye•Remote, FL, FL

11d

About The Position

The AR Appeals Specialist manages denied insurance claims, prepares and submits reconsiderations and appeals, and supports accurate reimbursement for healthcare services. The role requires analytical skills, knowledge of medical billing and coding, and the ability to navigate payer policies and systems. It is a full-time position with typical hours Monday through Friday, 8:00 A.M. to 5:00 P.M. Remote work may be considered. The employee may work in an office or remotely as needed and may need to travel between locations or to the office.

Requirements

High school diploma or GED required.

Nice To Haves

Prior healthcare billing experience preferred.
Certified Procedural Coder preferred.

Responsibilities

Analyze denied claims to determine the reason for denial.
Prepare and submit well-researched written appeals to insurance carriers.
Review coding, contracts, and medical records to support appeals.
Identify patterns and trends in denials to help prevent future occurrences.
Collaborate with upper management to present coding issues.
Escalate unresolved denial issues and communicate payer policy changes.
Track and follow up on reconsiderations and appeals within standard billing cycles.
Stay current with payer guidelines, regulatory changes, and compliance standards.
Document all actions taken on claims and appeals clearly and accurately.
Participate in quality improvement initiatives and special projects.
Communicate effectively with internal management, insurance companies, and patients.