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Appeals Specialist in Tennessee at Medical Data Systems

Recently UpdatedJob Function: Professional ServicesEmployment Type: Full-Time
Medical Data Systems
Tennessee, United States
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Job Description

Medical Data Systems Inc. is seeking a detail-oriented and motivated Insurance Appeals Specialist to join our insurance support and billing team. The ideal candidate will demonstrate professionalism, independence, and a strong understanding of insurance processes while thriving in a fast-paced environment.
Key Responsibilities
  • Perform insurance follow-up activities, including claim submission, claim status inquiries, and filing appeals for denied claims.
  • Process a high volume of detailed account information accurately and within established performance guidelines.
  • Navigate multiple systems to obtain insurance, contact, and attorney information as needed.
  • Support the prioritization of collections efforts by accurately updating account data and identifying next steps.
  • Maintain the highest level of confidentiality and adhere to all HIPAA regulations.
  • Apply hospital billing knowledge to carry out assigned duties efficiently.
Essential Duties
  • Complete insurance-related tasks such as correcting and resubmitting claims, filing appeals, and contacting insurance companies, attorneys, or patients regarding outstanding balances.
  • Work assigned facility-specific queues, ensuring all accounts are updated with correct and complete information.
  • Participate in special projects or assignments as directed.
  • Assist colleagues and management by providing information or support related to insurance processes when needed.
Qualifications
  • 3-5 years of experience in a healthcare setting such as a hospital business office, surgery center, physician practice, or health insurance organization.
  • Strong communication skills, attention to detail, and self-motivation.
  • Proficient knowledge of insurance processes, including claim submission, claim denials, HCPCS/CPT/ICD-10 coding basics, and claim status inquiries.
  • Familiarity with Medicare/Medicaid, Commercial, Auto, Workers’ Compensation, Liability, Crime Victims, and State/Federal Insurance Programs.
  • Experience with medical billing and collection practices, business office procedures, and multi-system computer navigation.
  • Ability to type at least 55 words per minute.
  • High School Diploma or GED required; some college preferred.
Position Details
  • Employment Type: Full-Time

Job Location

Tennessee, United States

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