Appeals Specialist

Appeals Specialist

LHH Recruitment Solutions is hiring an Appeals Specialist for our client based out Seattle, WA. This position will be 100% onsite in either Portland, Seattle, and/or Boise, ID. The role will be a full-time, long-term contract opportunity for the team. This position is responsible for reviewing, investigating, and resolving member, provider, and facility appeals related to claim denials, coverage determinations, medical necessity, and benefit interpretation. This role ensures appeals are processed accurately, timely, and in compliance with applicable federal, state, and regulatory requirements. Interested candidates must feel comfortable collaborating with internal departments and external stakeholders to support fair and compliant resolution outcomes.

Requirements

• High School Diploma or equivalent requirement
• CPC Certification strongly desired (not required)
• Minimum 2 years medical claims/appeals experience
• Must be proficient working within multiple software systems including Microsoft Office
• Can work well in a fast-paced, productivity-driven environment
• Able to meet deadlines and work well under pressure

Pay Details: $20.00 to $25.00 per hour

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.

Equal Opportunity Employer/Veterans/Disabled Military connected talent encouraged to apply

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

• The California Fair Chance Act
• Los Angeles City Fair Chance Ordinance
• Los Angeles County Fair Chance Ordinance for Employers
• San Francisco Fair Chance Ordinance

Massachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.