Job Title: Substance Abuse Claims Appeals Specialist

Port St Lucie, FL

About Us:

Aspire Medical Billing is dedicated to providing comprehensive support and resources for individuals dealing with substance abuse issues. We are committed to ensuring our clients receive the best possible care and support through their treatment journey.

Position Overview:

The Substance Abuse Claims Appeals Specialist is responsible for managing and processing appeals related to substance abuse treatment claims. This role requires a deep understanding of substance abuse treatment protocols, insurance policies, and the appeals process to effectively advocate for clients and resolve disputes with insurance providers.

Key Responsibilities:

Review and analyze denied or underpaid claims related to substance abuse treatment to identify the reasons for denial.

Develop and submit comprehensive appeals to insurance companies, ensuring all necessary documentation and information is included.

Communicate with insurance providers, healthcare professionals, and clients to gather additional information and clarify details as needed.

Monitor and track the status of appeals to ensure timely resolution and follow up as necessary.

Maintain detailed records of all appeals and correspondence related to each case.

Stay current with changes in insurance policies, regulations, and substance abuse treatment standards to provide accurate and effective support.

Collaborate with internal teams, including case managers and healthcare providers, to ensure cohesive and effective appeals strategies.

Provide support and guidance to clients and their families regarding the appeals process and their rights.

Develop and submit comprehensive appeals to insurance companies utilizing various methods such as portals, facsimile and mail to ensure all necessary documentation and information is included

Qualifications:

Bachelor’s degree in healthcare administration, business, or a related field; or equivalent work experience.

Previous experience in claims processing, appeals, or substance abuse treatment is highly desirable.

Strong understanding of insurance policies and the appeals process, particularly related to substance abuse treatment.

Excellent communication skills, both written and verbal, with the ability to clearly convey complex information.

Strong organizational skills with attention to detail and the ability to manage multiple cases simultaneously.

Proficiency in using claims management software and other relevant tools.

Ability to work independently and as part of a team in a fast-paced environment.

Why Join Us? At Aspire Medical Billing, we value our employees and offer a supportive work environment with opportunities for professional growth and development. We offer competitive compensation and benefits packages.

Aspire Medical Billing is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job Type: Full-time

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Ability to Commute:

• Port Saint Lucie, FL 34953 (Required)

Ability to Relocate:

• Port Saint Lucie, FL 34953: Relocate before starting work (Required)

Work Location: In person