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Appeals Specialist

With decades of experience in the substance abuse and mental health rehab industry, the team at Infinity Behavioral Heath Services, Inc. (INFINITY), is committed to easing the insurance claim process and to maximizing insurance benefits so its clients can provide the highest levels of clinical care for every patient. In addition to a proven process for billing and claims follow-up, INFINITY offers utilization management and business consulting services to help clients improve day-to-day operations, increase revenue and maintain regulatory compliance.

INFINITY is now seeking Appeals Specialists to join our team. 

INFINITY offers competitive compensation, a comprehensive wellness benefits and perks package and a great time off policy. Our health benefits include: medical (4 options), dental, vision, company-paid short term disability and voluntary - life insurance and long term disability plans. Financial wellness benefits include: 401(k) plan at completion of initial 90-days with employer match at completion of 1 year employment, as well as free financial wellness seminars. Our perks include: break rooms stocked with coffee and healthy snacks, monthly on-site massage, free gym memberships, team outings and other rewards for meeting company goals, a positive and FUN team-oriented and pet-friendly environment. We believe in developing our talent from within, as such, we offer a tuition reimbursement program and career advancement opportunities. 

INFINITY is dedicated to its employees’ success. For more information, check us out at www.infinitybehavioral.com.

 

General Summary Of Duties:

Works to resolve issue claims by reviewing and submitting medical records to insurance companies for medical necessity review and files appeals on behalf of the facilities and patients.

Primary Responsibilities: 

  • Reviewing charts and claims for accuracy.
  • Writing appeals to prove medical necessity with clinical information provided.
  • Prepares and sends medical records as requested.  
  • Other duties may be assigned.

Qualifications And Education Requirements:

  • Ability to read and interpret documents such as medical records, clinical documentation, insurance correspondence and legal documents.
  • Ability to interpret clinical documentation and write letters of medical necessity. Understand verbiage related to denials (administrative and clinical), benefits, and levels of care.
  • Ability to understand what type of chart submission is required and identifies discrepancies within medical records in relation to billing.
  • Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
  • To perform this job successfully, an individual should have knowledge of word processing software; spreadsheet software; internet software and database software.
  • Minimum 1 year experience required.
  • Minimum H.S. diploma or equivalent. Associate's degree (A.A./A.S.) or equivalent from two-year college or technical school a plus; or one to two years related experience and/or training; or equivalent combination of education and experience preferred
  • CPC/CSS certification a plus.

 

INFINITY - EEO (Equal Opportunity Employer). eoe/m/f/d/v/so 

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