Medlogix

Appeals Analyst

Medlogix

full-time

Posted on:

Location: 🇺🇸 United States

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Salary

💰 $50,000 - $55,000 per year

Job Level

Mid-LevelSenior

About the role

  • Ensure compliance with HIPAA regulations including privacy and confidentiality
  • Coordinate and respond to post-service appeals to managed care/insurance denials
  • Conduct comprehensive reviews on provider bill denials to determine appeals
  • Review and respond to provider bill appeals on auto claims for multiple carriers
  • Maintain multiple databases pertaining to denials and case management
  • Apply New Jersey state auto PIP regulations
  • Process bill review for auto claims using the MyMedlogix system
  • Identify problematic issues and address with appropriate departments
  • Handle post-service appeals for multiple states
  • Other duties as assigned

Requirements

  • Bachelor’s degree from an accredited college or university
  • Knowledge of prior carrier or adjuster experience
  • Knowledge of New Jersey No Fault PIP regulation (1-2 years preferred)
  • Experience with post-service appeals and medical claims processing
  • Proficiency with proprietary software and MyMedlogix system
  • Excellent problem solving, critical thinking and decision-making skills
  • Good communication skills, able to communicate clearly and succinctly, both verbally and in writing
  • Good organizational skills
  • Ability to work in a climate-controlled office environment when required
  • Minimal physical requirements
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