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Medical Collector

Addison Group
Edmond, OK Full Time
POSTED ON 1/23/2025
AVAILABLE BEFORE 4/21/2025

Job Title : Claims Appeals Specialist

Location : Oklahoma City, OK

Pay Rate : $18-22 / hr

Assignment Type : Direct Hire

Industry : Healthcare - Claims Processing

About the Role :

The Claims Appeals Specialist will handle denied claims for a healthcare provider, focusing on identifying denial reasons, resolving issues, and filing appeals for government and commercial claims. This role requires previous experience with provider claims and appeals / denials resolution. Candidates should be proficient in Epic and will be expected to meet daily productivity standards after a 90-day onsite training period.

Key Responsibilities :

  • Review daily claims denial list from Epic and prioritize based on urgency and type of claim.
  • Analyze denied claims, determine the cause, and identify the appropriate corrective action.
  • File appeals or obtain additional documentation needed to process denied claims, including adding modifiers and submitting authorizations.
  • Work with both government and commercial claims for accurate and timely resolution.

Qualifications :

  • 2-5 years of experience in provider claims with a focus on appeals and denials.
  • Prior experience with Epic or similar claims processing systems.
  • Strong knowledge of claims processing, including government and commercial claims.
  • Ability to work independently and efficiently to meet productivity standards.
  • Minimal need for extensive training - candidates should have experience with minimal onboarding requirements.
  • Work Schedule :

  • Full-time : During training, hours are standard 8-5
  • After training, schedule flexibility will be offered based on performance.
  • Onsite Requirement : Must be on-site for the first 90 days; remote work may be available after this period, contingent on meeting performance metrics.
  • This Claims Appeals Specialist role is a great fit for candidates with a strong background in healthcare claims, particularly with provider appeals and denials. The client is committed to securing high-quality talent and is flexible with pay for the right experience.

    Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.

    Salary : $18 - $22

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