A medical biller focused on denial and appeals management plays a pivotal role in safeguarding revenue integrity by addressing claim rejections and securing rightful reimbursements. Reviews explanation of benefits (EOBs) and remittance advice to identify reasons for claim denials, such as coding errors, missing documentation, or eligibility issues. Prepares and submits formal appeals to insurance payers, including supporting medical records, corrected claim forms, and detailed justifications for reconsideration. Monitors appeal timelines and payer responses to ensure timely follow-up and resolution. Identifies patterns in denials and communicates findings to billing and coding teams to improve claim accuracy and reduce recurrence.
