Insurance Appeals Specialist

Responsible for managing denied hearing aid and audiologist claims with commercial payers including BCBS and Aetna. Reviewed EOBs and denial codes, drafts and submits fist and second level appeals, ensures documentation supports medical necessity (degree/type of loss, functional impact and need for binaural amplification), and tracks deadlines and outcomes. Collaborated with providers to strengthen chart notes, submit supporting documentation through payer portals (eg: Availity) and communicated directly with insurance representatives to resolve denials. Maintains appeal tracking reports and identified denial trends to reimbursement success

Required: Experience with commercial insurance appeals, audiology billing (CPT/ HVPCS V Codes), strong written communication and attention to detail.