Investigate, resolve, and appeal complex insurance denials while ensuring accurate and timely reimbursement.
About VitalConnect
VitalConnect is a leading innovator in healthcare technology and patient financial engagement, dedicated to streamlining medical billing and revenue cycle processes. Our goal is to deliver seamless financial experiences for patients, physicians, and providers while helping healthcare organizations maximize reimbursements.
Schedule
- Location: Fully Remote (U.S.)
- Employment Type: Full-Time
- Flexible schedule, but must meet established productivity standards and payer timelines.
- Reports to the Patient Financial Engagement Manager.
Responsibilities
- Investigate and resolve third-party insurance denials, ensuring compliance with Medicare, Medicaid, and commercial payer guidelines.
- Research claims related to referrals, authorizations, medical necessity, non-covered services, and delayed payments.
- Prepare and submit professional, compelling appeal letters based on clinical documentation and payer policies.
- Track recovery efforts, identify denial trends, and recommend solutions to minimize future issues.
- Collaborate with patients, providers, insurance reps, and internal stakeholders for accurate claim resolution.
- Access and manage payer portals (Navinet, Availity, etc.) for claim status updates and appeal submissions.
- Review and reconcile daily payer correspondence, following up to ensure timely resolution.
- Maintain compliance with HIPAA and confidentiality requirements.
Requirements
- Education: Bachelor’s degree or equivalent experience.
- Experience: 3+ years in medical collections, denials, appeals, and insurance follow-up.
- Advanced understanding of healthcare billing processes, payer policies, and CPT/ICD-10 coding.
- Knowledge of insurance plan types (HMO, PPO, IPO, etc.) and coordination of benefits.
- Excellent written communication skills with the ability to craft detailed, persuasive appeal letters.
- Strong problem-solving, decision-making, and time-management skills.
- Proficiency with Microsoft Office, payer portals, and claim tracking systems.
- Must successfully pass a background and credit check due to financial responsibilities.
Salary & Benefits
- Salary Range: $22/hr – $24/hr (based on experience, skills, and location)
- Comprehensive benefits package including:
- Medical, dental, and vision coverage
- 401(k) retirement plan
- Paid time off and company holidays
Happy Hunting,
~Two Chicks…