Location: Clearwater, FL
Employment: Full-time
Position Overview:
ROMTech is seeking a detail-oriented and proactive Appeals Specialist to join our internal Revenue Cycle team. The Appeals Specialist is critical to ensuring accurate and timely resolution of insurance claims and appeals for our medical devices, contributing directly to our financial health and patient satisfaction.
This is a full-time position based on site at our corporate office in Clearwater, FL. Reporting directly to the Director of A/R.
Responsibilities:
- Review and analyze denied insurance claims to determine appropriate appeal strategies.
- Prepare and submit appeals to insurance providers, ensuring compliance with payer guidelines and timelines.
- Collaborate with billing, coding, and clinical teams to gather necessary documentation for appeals.
- Monitor appeal outcomes and follow-up on unresolved cases.
- Maintain accurate records of all claims and appeals activity in the system.
- Performs other related duties as required or requested.
Requirements:
- Proven experience in medical billing, claims processing, or revenue cycle management, preferably in a medical device or healthcare setting.
- Deep understanding of insurance guidelines, EOBs, and appeal processes.
- Excellent written and verbal communication skills.
- Ability to work independently and manage multiple priorities in a fast-paced environment.
- Ability to sit at a computer terminal for an extended period.
- Moderate noise (i.e., phone calls, online meetings, computer audio)
- While performing the duties of this job, the employee may be regularly required to stand, sit, talk, hear, reach, stoop, kneel, and use hands and fingers to operate a computer, telephone, and keyboard.
- Specific vision abilities required by this job include close vision requirements due to computer work.
- Regular, predictable attendance is required.
If this sounds like an exciting opportunity to embark in the next chapter of your career, please respond and include an up-to-date resume.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit for extended periods of time and use hands to operate a computer and other office equipment. The employee is frequently required to reach with hands and arms, talk, and hear. Specific vision abilities required by this job include close vision and the ability to adjust focus.
We are an equal opportunity employer. Qualified Applicants are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status, or any other classification protected under applicable Federal, State or Local law