Job Summary
The Appeals Specialist examines and resolves insurance denials to support accurate reimbursement and compliance with applicable regulations. The role also monitors denial patterns, shares insights with facilities, and keeps relevant stakeholders informed about payer updates.
Responsibilities
- Review and analyze insurance denials, and take appropriate steps to resolve them.
- Help ensure reimbursement is accurate and processes comply with regulatory requirements.
- Track denial trends and provide feedback to facilities.
- Communicate payer updates to relevant stakeholders.
Qualifications
- Associate Degree or higher in Nursing, Radiologic Technology, Physical Therapy, or Occupational Therapy.
- One to three years of experience in clinical operations.
- Relevant licensure as a Licensed Practical Nurse (LPN) or Radiologic Technologist.
Community Health Systems Professional Services Corporation provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
