Appeals Specialist

Responsibilities

• Review and analyze denied claims, payment discrepancies, and reimbursement issues to identify the root causes.
• Initiate and manage the appeals and arbitration process for denied or underpaid claims, ensuring timely and accurate submissions.
• Prepare compelling appeal letters, supporting documentation, and necessary forms to present a strong case for claim reconsideration.
• Stay up-to-date with payer policies, regulations, and industry trends related to claim appeals and arbitration.
• Maintain a comprehensive understanding of coding guidelines, medical necessity, and reimbursement methodologies to strengthen appeal arguments.

Ms office suite, medical record, medical terminology, medical biller, anesthesia

• Proven experience as an Appeals Specialist or in a similar role within a healthcare setting.
• In-depth knowledge of healthcare revenue cycle processes, claim adjudication, and reimbursement methodologies.
• Familiarity with insurance denials, appeals, and arbitration processes, including knowledge of payer-specific appeal requirements and guidelines.
• Strong understanding of medical coding (CPT, HCPCS, ICD-10) and medical terminology.

Intermediate Level

This is a Contract to Hire position based out of Addison, TX.

The pay range for this position is $21.00 - $28.00/hr eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

This is a fully onsite position in Addison, TX.

This position is anticipated to close on Feb 19, 2026.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.