Appeals Specialist
The Appeals Specialist at Adaptive Biotechnologies will join a dynamic and collaborative reimbursement operations team dedicated to ensuring seamless insurance claims and payment processes for advanced diagnostics in the biotechnology sector. The company is a leader in immune-driven medicine, leveraging its expertise to make a lasting impact in patient outcomes through cutting-edge technology and research. This role is key to supporting patients, providers, and the company's mission by managing appeals in alignment with healthcare regulations and Adaptive’s standards.
Primary responsibilities include analyzing, preparing, and submitting appeals for denied insurance claims specifically related to Adaptive’s immuno-based products and services. The specialist will review claim documentation, explain coverage decisions, gather necessary medical records and supporting data, and communicate effectively with payers to resolve complex reimbursement issues. Daily work involves collaborating closely with billing, coding, and customer support teams while tracking appeal outcomes and identifying process improvements.
The ideal candidate has a thorough understanding of healthcare insurance processes, particularly in medical billing and reimbursement appeals. Essential qualifications include an associate’s degree or higher, at least 2 years of relevant experience in appeals or insurance follow-up, and strong analytical, research, and communication skills. Experience with healthcare billing software and knowledge of commercial, government, and managed care payer requirements are preferred.
Adaptive Biotechnologies offers a comprehensive benefits package, which includes health, dental, and vision insurance, a 401(k) plan with company contribution, paid time off, and opportunities for professional development. Employees also enjoy wellness programs and flexible hybrid work options.
Adaptive fosters an inclusive, innovative, and mission-driven culture, encouraging growth and continuous learning within a supportive environment. Team members are valued for their expertise and commitment to improving patient health outcomes through science and technology. This is an exceptional opportunity for individuals passionate about making a difference in the healthcare landscape.