Appeals Specialist

Detail-oriented and analytical, the remote Billing & Appeals Specialist will manage provider billing disputes and appeals, ensuring accurate resolutions while maintaining exceptional customer service in a contract role. Key responsibilities Review, investigate, and resolve provider billing disputes and appeals in accordance with guidelines Analyze claims and reimbursement policies to determine appropriate non-clinical appeal outcomes Coordinate with clinical reviewers and cross-functional teams to ensure timely processing of appeals Required qualifications 4+ years of experience in health insurance claims, appeals, or related healthcare operations Experience supporting high-volume provider appeals, including Independent Dispute Resolution (IDR) processes preferred Working knowledge of medical terminology, coding systems, and health plan claims processing principles Strong analytical and organizational skills with the ability to manage multiple priorities Proficiency with Microsoft Office applications and clear communication of complex claims information