Job Title: Pre-Services & Appeals Specialist

 

About the Company:

Our client is a professional services firm specializing in medical claims processing and authorizations. They assist healthcare providers in navigating the complex world of pre-service authorizations, appeals, and post-service appeals. As part of their growing team, they are looking for a highly organized and detail-oriented professional to support their operations independently.

 

Job Description:

We are seeking a Pre-Services & Appeals Specialist to take full ownership of medical pre-service and post-service appeal processes. This is a remote role for a proactive, self-directed individual with strong experience in billing and collections within the medical field. The selected candidate will manage documentation, ensure accuracy in submissions, and handle phone communications with clients and suppliers during the workday.

 

Responsibilities:

• Independently manage pre-service authorizations for medical claims.

• Oversee the full lifecycle of pre-service and post-service appeals.

• Merge, edit, and organize narrative reports for claims processing.

• Ensure all required documentation is complete and submitted by the end of each workday.

• Maintain high accuracy and attention to detail when handling medical forms.

• Conduct phone calls with clients and suppliers as needed during the shift.

 

Required Experience and Qualifications:

• Proven experience in billing and collections in the medical field.

• Strong computer skills, particularly in document merging, formatting, and editing.

• Highly organized and detail-oriented in managing medical records and documentation.

 

Preferred Skills:

• Proactive and self-motivated mindset with the ability to work independently.

• Familiarity with medical terminology and claims processes (not mandatory).

 

Personality:

• Self-directed, proactive, and highly organized.

 

Software & Tools:

• Google Meet.

 

English Level:

C2

 

Schedule:

9-5 EST

 

Salary and Benefits:

Payment in USD or Local Currency according to candidate's preference.