Appeals Specialist

Job not on LinkedIn

🔥 5 minutes ago

🇺🇸 United States – Remote

💵 $22 - $27 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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Adaptive Biotechnologies Corp.

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2009

🏥 Healthcare

🧬 Biotechnology

⚕️ Healthcare Insurance

💰 $125M Post-IPO Debt on 2022-09

Healthcare • Biotechnology • Healthcare Insurance

Adaptive Biotechnologies Corp. is a leader in immune-driven medicine, aiming to revolutionize disease detection and treatment. By utilizing the adaptive immune system, the company develops diagnostic and therapeutic solutions powered by its innovative Immune Medicine platform. They offer clinical diagnostics, particularly in Minimal Residual Disease (MRD) testing, and engage in drug discovery and therapeutic development through adaptive immunosequencing technologies. Their biopharma services support the progression of clinical trials and the development of transformative medicines. Adaptive Biotechnologies leverages the complex biology of the immune system, decoding it to advance medical science and improve patient outcomes.

📋 Description

• Review denied claims and determine appropriate appeal strategy based on payer guidelines • Prepare and submit appeal letters with supporting documentation • Submit appeals through payer-preferred portals, fax, or mail within payer-specific timelines • Track appeal status and maintain accurate billing-system records • Contact insurance companies to confirm receipt and appeal progress • Escalate unresolved appeals or complex cases to management • Stay current on payer policies and appeal requirements for molecular and genetic testing • Ensure appeal activities comply with HIPAA and regulatory standards • Identify denial trends and collaborate with reimbursement teams to reduce future occurrences • Collaborate with prior authorization, billing, and payer relations teams • Communicate with providers when additional clinical information is required • Perform other duties as assigned

🎯 Requirements

• High school diploma required • 2 years in insurance appeals, medical billing, or revenue cycle operations • Strong understanding of insurance processes and denial management • Excellent written and verbal communication skills • Proficiency in billing systems and Microsoft Office Suite • Detail-oriented and organized • Ability to work independently and manage multiple priorities • Strong problem-solving and critical thinking skills • Flexibility to work out of standard hours when necessary, including nights, weekends, and holidays • Adaptive is not currently sponsoring candidates requiring work authorization support for this position

🏖️ Benefits

• Equity grant • Bonus eligible • Affirmative Action and Equal Opportunity Employer • Reasonable accommodation support for disabled job seekers