Revenue Cycle Medical Billing Clinical Insurance Appeal Writer

Revenue Cycle Medical Billing - Clinical Insurance Appeal Writer

(must have be a licensed Registered Nurse)

Location: Remote or On-Site, United States

Annual Compensation: $70,000

(this position is bonus eligible)

Schedule: Full-Time

Job Summary

The Clinical Insurance Appeal Writer providesmedical necessityjustificationfor air transportevaluation and evaluation/submission of all medical necessity appealsfor government and commercial payors.Utilizesclinical flightexperience,establishedclinical standards and protocols tovalidateair medical necessity and appeal payment denials.

Essential Functions/ Duties

• Conducts the medical necessity appeals for all payor sourcesin the role of advocate for the patient andGMR.
• Receives the appeal request fromtheAppeal Prepperand inputs the information into theappealsdatabase.
• Ensures appealtimelines are met by moving the assigned book of business through the appeals process and updates appealsdatabase.

• Works withfixed deadlines anddemonstrateswillingness to meet and exceed performancemetrics.
• Works with theAppeal teamtodeterminethe best approach to each clinical denialin order tomaximizeclaimreimbursement and minimize the financial risk to patientsand GMR.
• Maintainsstrict confidentiality of all protected health information andcooperatesfully with all informationsecurity guidelinesrelated to the scope ofwork.

Qualifications

Required Experience:

• Minimum of five years in Emergency department (ED), Intensive Care Unit (ICU), flight or ambulance experience or job experience equivalent
• Some supervisory/leadership experience preferred(i.e.: team leader, FTO, charge nurse, preceptor, educator, etc.)
• Proficient in Word, Excel, Office 365

Education/Licensure:

• Current RN licensure, isrequired
• Bachelor's degree in nursing or equivalent,ispreferred
• CFRN, CEN or CCRN, ispreferred

Skills

• Excellent written communication skills
• Ability to define andidentifyproblems, collect data,establishfacts, and draw validconclusions
• Ability to respond to inquiries or complaints from customers in a positive and productivemanner
• Ability to calculate numbers, correct entries, and post torecords
• Ability to gather data from hospital and EMS charts, phone calls, emails, colleagues, and internet research, then compile information and prepare reports and letters
• Ability to use independent judgment and to manage and impart confidential information
• Ability to research local EMS protocols, hospital referrals, and standards of care
• Ability to review clinical charts and development of constructive feedback

Why Choose Air Evac Lifeteam? As a leader in helicopter air ambulance services, Air Evac Lifeteam is one of Global Medical Response's (GMR) family of solutions. Our GMR teams deliver compassionate, quality medical care, primarily in the areas of emergency and patient relocation services. View the stories on how our employees provide care to the world at www.AtaMomentsNotice.com.

GMR's Core Behaviors-keep care at the center, raise your hand, seek to understand, find a way together and be accountable-unite our teams and set us apart in emergency medical services.

Global Medical Response and its family of companies are an Equal Opportunity Employer, which includes supporting veterans and providing reasonable accommodations for individuals with a disability.

Check out our careers site benefits page to learn more about our benefit options.