Senior Appeals Specialist - Remote

Overview

The Sr Appeals Specialist will be responsible for designing and implementing an appeal strategy to optimize reimbursement success and reduce claim denials. This role focuses on enhancing the appeals process and collaborating with various teams to ensure effective appeals handling.

In Short

• Develop and implement an appeals strategy.
• Conduct root-cause analysis of denied claims.
• Create and optimize appeal templates and workflows.
• Monitor regulatory changes and payer policies.
• Track and report on appeal outcomes.
• Serve as a subject matter expert on appeal processes.

Requirements

• Bachelor’s degree + 5 years of experience in healthcare.
• 5+ years in healthcare reimbursement.
• Knowledge of medical billing and coding standards.
• Strong analytical and communication skills.
• Experience with revenue cycle management.
• Familiarity with healthcare software solutions.

Benefits

• Equity grant.
• Bonus eligible.