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Appeals and Denials Representative – Veterans Administration

Alegis, A MedData Company
The Woodlands, TX Full Time
POSTED ON 1/12/2025 CLOSED ON 3/11/2025

What are the responsibilities and job description for the Appeals and Denials Representative – Veterans Administration position at Alegis, A MedData Company?

Company Description

Alegis/ MedData is among the nation’s leading providers of medical billing services. For over 3​5 years, MedData has solidified its leadership position within the billing sector by expanding upon and redefining the typical revenue cycle management processes of coding, billing, and collections. 

MedData serves ​5,000 physicians across a growing network of 1,000 facilities throughout the U.S., having built a national presence by becoming experts at the state level. To date, we have handled billing for more than ​200 million patients. 

Job Description

Alegis seeks an Appeals and Denials Representative with knowledge on the billing and the reconsideration process for the Veterans Administration Non-VA Care benefits. Responsibilities will include but are not limited to:

• Review of new claim referrals; for initial billing; billing follow-up; or preliminary determination whether denial can be overturned with a reconsideration;   

• Request of any necessary documentation needed in order to initially bill claims; prepare reconsideration;

• Prepare and submit initial bill or reconsideration to the Veterans Administration;

• Monitor accounts for updates on claim/reconsideration status;

• Post Veterans Administration payments in Account Management software;

• Inform supervisor of trends noticed when working denials.


Qualifications

• A minimum of a high school diploma;

• Strong computer skills including Microsoft Excel, and Word;

• Able to communicate (both written and verbal) in a professional manner;

• Ability to multi-task and work with minimal supervision;

• Required to have at least one year of experience in hospital billing or appealing Veterans Administration denials;

• Requires exceptional attention to detail and demonstrated ability to prioritize work to ensure accuracy and timely completion of assigned work;

• Requires investigational and analytical skills;

• Knowledge of Veterans Administration Benefits and government payers including Medicare and Medicaid;

• Knowledge in hospital and insurance reimbursement and billing concepts and procedures, as well as laws and regulations affecting payment compliance, denials and appeals recovery;


Additional Information

All your information will be kept confidential according to EEO guidelines.  

This is a Hourly, Non-Exempt position. We offer an exceptional benefits package which includes Medical, Dental, Vision, Life Insurance, Short and Long Term disability as well as a 401K plan. 

MedData  provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws.

Pay is commensurate with experience Benefits, Sick & Vacation time, and paid holidays


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