We have an exciting opportunity for you to join our team as a Clinical Appeals Specialist. In this
position, you will play a vital role in delivering our “Service First” value proposition to our patients,
therapists, and physician stakeholders. As a member of our team, you will have an opportunity for
personal and professional growth and career advancement as we build on our consecutive years of
significant growth. In addition to base pay, our employees are eligible for bonuses based on
personal and company performance.

We are also proud to have been recognized for our amazing workplace and culture, including being selected for the last 5 consecutive years as one of the:

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• Best Employers in Ohio by Crain’s Magazine

• Top Employers in Cleveland by Cleveland.com and The Plain Dealer

• Top Workplaces for Top Talent in Northeast Ohio by North Coast 99

• Crain Magazine’s Fast 50 – one of the 50 fastest growing businesses in Northeast Ohio over

• the last 5 years

Do not miss this opportunity to find career success with a forward thinking, entrepreneurial, and
growing company.

Summary:

The Clinical Appeals Specialist partners with the sales team, therapists, and Insurance Liaison to improve
insurance approval rates for Complex Rehab Technology (CRT) equipment. This role investigates denials,
identifies documentation gaps, collaborates with therapists to strengthen medical necessity support, and
manages appeals through resolution. The position also analyzes denial trends and helps improve
documentation and reimbursement processes to increase first-pass approvals.

Main responsibilities:

• Manage insurance appeals from denial through final resolution.

• Review denials to identify documentation deficiencies and develop corrective action plans.

• Obtain, organize, and submit supporting documentation.

• Monitor appeal deadlines and maintain accurate appeal records.

• Coordinate communication among therapists, sales representatives, facilities, and internal
  teams.

• Work directly with therapists to clarify documentation and strengthen medical necessity
  justification.

• Serve as a resource for documentation and reimbursement questions.

• Collaborate with sales representatives and healthcare facilities to obtain necessary information.

• Travel as needed to facilitate documentation collection and appeal support.

• Analyze denial trends and payer requirements to identify improvement opportunities.

• Develop best practices, educational resources, and documentation guidelines.

• Recommend process improvements that reduce denials and improve reimbursement
  outcomes.

• Support ongoing initiatives to increase efficiency and approval rates.

Qualifications

• Active Assistive Technology Professional (ATP) certification.

• Experience in a clinical/health care related field.

• Clean driving record with the ability to travel extensively throughout the assigned territory.

• Ability to work independently while exercising sound clinical judgment and professional

• decision-making skills.

• Strong interpersonal, communication, and problem-solving abilities when working with

• patients, caregivers, therapists, physicians, and referral partners.

• Effective ability to prioritize competing responsibilities while maintaining attention to detail

• and meeting deadlines.

Apply Here

NPL Home Medical is an Equal Opportunity Employer. NPL Home Medical does not discriminate against any person on the basis of gender, race, color, national origin, religion, disability, age, veteran status, gender identity or sexual orientation in admission, treatment, or participation in its programs, services and activities, or in employment, or on the basis of gender in its health programs and activities.

Job Type: Full-time