Appeals Specialist - Medical Billing & Insurance Appeals
About the job
- A high school diploma or GED is required.
- At least one year of recent experience in medical billing, insurance appeals, denial management, or healthcare revenue cycle is required.
- Experience using electronic health record and medical billing software is required.
- Ability to work full-time in the Doraville office is required.
- Strong analytical and critical-thinking abilities are required.
- Attention to detail and accuracy are required.
- Written and verbal communication skills are required.
- Ability to prioritize multiple tasks while meeting deadlines is required.
- Organizational and time-management skills are required.
- Ability to work independently while contributing to a collaborative team environment is required.
- Proficiency with Microsoft Office and medical billing software is required.
- Review denied and underpaid insurance claims to determine the appropriate appeal strategy.
- Prepare, submit, and track insurance appeals in accordance with payer guidelines and filing deadlines.
- Research payer policies and identify supporting documentation necessary for successful appeal submissions.
- Work with billing staff and clinical teams to obtain required medical documentation.
- Monitor appeal status and follow up with insurance companies to ensure timely resolution.
- Maintain accurate documentation of appeal activity within billing systems.
- Identify denial trends and communicate findings to leadership to improve reimbursement outcomes.
- Ensure compliance with HIPAA, payer regulations, and company policies.
- Assist with additional revenue cycle projects as assigned.
- Experience working with Medicare, Medicaid, and commercial insurance payers.
- Knowledge of CPT, ICD-10-CM, and HCPCS coding.
- Experience with CollaborateMD, Kipu EMR, or Availity.
About the company
NANA Healthcare Management manages behavioral health treatment programs and related healthcare businesses in Georgia. Its treatment-center network coordinates adult and adolescent mental health and substance use care through residential, day-treatment and outpatient programs. Clinical teams assess each client, build a treatment plan and combine counseling, medication management and structured support as needs change. Management and medical billing teams support facility operations and work with providers and insurers on reimbursement for care. The company is headquartered in Dunwoody, Georgia, where its programs and administrative functions support the wider treatment network.
Company Size
201-500
Company Stage
N/A
Total Funding
N/A
Headquarters
Dunwoody, GA
Founded
N/A
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Simplify's Take
What believers are saying
- Mount Yonah Medical Billing's full-time Doraville Appeals Specialist works in-office; health coverage starts after 60 days, dental/vision/life after 90.
- Performance-bonus eligibility begins after 90 days for Mount Yonah Medical Billing's full-time, in-office Doraville Appeals Specialist.
- Atlanta Recovery Place trains its full-time, on-site Dunwoody Primary Therapist in crisis prevention and CPR free for certification gaps.
What critics are saying
- SLOW's part-time Dunwoody registered nurses work as needed, nights or weekends; hours aren't guaranteed.
- The full-time registered nurse at SLOW Academy in Dunwoody works 12-hour daytime shifts, from 7 a.m. to 7 p.m.
- SLOW asks Dunwoody part-time Behavioral Health Technicians about every-weekend availability and 10-12-hour shifts.
What makes NANA Healthcare Management, LLC unique
- Southern Live Oak Wellness (SLOW) follows alumni through monthly wellness checks, weekly meetings and monthly social events.
- NANA's SLOW network includes Phoenix Supportive Housing, a dedicated adult living program.
- SLOW Academy's Dunwoody eating-disorder program has eight inpatient beds, combining medical and psychiatric nursing with nutritional rehabilitation.
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