Healthcare Appeals and Collections Specialist

Job Description

Job Description

Title: Healthcare Appeals and Collections Specialist Location: Edina, MN Job Type: Contract Compensation: $23-25/hr, potential flex for the right candidate Industry: Medial Device --- About the Role We are hiring an Appeals and Collections Specialist on behalf of our client, a medical technology company serving the healthcare and workers' compensation industry. In this role, you will be responsible for recovering outstanding revenue by managing denied, delayed, underpaid, and unpaid workers' compensation claims. You will own assigned accounts from initial review through appeal, collection, and payment resolution. The ideal candidate has strong workers' compensation billing and appeals experience, is comfortable communicating directly with payers and adjusters, and can independently manage a high-volume workload. This position also offers the opportunity to support AI-assisted appeal workflows and process improvements. Job Description Review EOBs, denial codes, claim histories, supporting documentation, and payment records to determine appropriate next steps. Prepare and submit first-, second-, and third-level appeals based on payer and jurisdiction requirements. Compile complete appeal packages using clinical records, prescriptions, authorizations, billing documentation, fee schedules, and other supporting information. Track appeal and Second Bill Review (SBR) deadlines, submissions, responses, and outcomes. Research underpayments and reimbursement discrepancies and provide appropriate supporting documentation. Manage assigned accounts through resolution or documented handoff. Contact adjusters, third-party administrators (TPAs), and payer representatives to resolve outstanding balances and payment issues. Build productive relationships with workers' compensation payers and claims administrators. Obtain payment commitments, document expected timelines, and follow up until accounts are resolved or require escalation. Prioritize collections based on account age, balance, filing deadlines, and recovery opportunities. Investigate payment discrepancies and coordinate reconciliation with internal billing teams. Use DaisyBill to manage appeals, SBR activity, payer information, work queues, and reporting. Use NetSuite for invoice research, payment references, and authorized account updates. Maintain accurate documentation of communications, collection activity, deadlines, next steps, and outcomes. Collaborate with billing, authorization, order entry, and care teams to resolve claim issues and obtain required documentation. Review AI-assisted appeal content for accuracy, relevance, appropriate references, and completeness before submission. Identify recurring denial trends and recommend improvements to billing, documentation, authorization, and follow-up processes. Stay current on state- and payer-specific workers' compensation billing, fee schedule, appeal, and submission requirements. Qualifications Required Qualifications: High school diploma or equivalent. At least 5 years of relevant workers' compensation appeals, billing, accounts receivable, collections, or denial resolution experience. Strong understanding of workers' compensation claim lifecycles, reimbursement processes, fee schedules, appeals, and denial resolution. Demonstrated experience resolving aged accounts and pursuing payment on denied or underpaid claims. Strong written and verbal communication skills, including appeal writing and payer communication. Strong negotiation, analytical, and problem-solving skills. Ability to independently manage high-volume work queues, competing priorities, and time-sensitive deadlines. Strong attention to detail and accurate documentation skills. Proficiency with Microsoft Office or Google Workspace and the ability to learn billing and reporting systems. Sound judgment when handling escalations, payment resolutions, and confidential information. Preferred Qualifications: Associate degree or certification in healthcare administration or a related field. Multi-state or national workers' compensation experience. Experience with DaisyBill, NetSuite, Dialpad, and Box. Experience with durable medical equipment (DME) billing and reimbursement. Familiarity with Second Bill Review (SBR) processes. Experience using AI-assisted workflows or tools to support appeals and claims processing. Experience with Power BI or similar reporting tools. Benefits Dahl Consulting is proud to offer a comprehensive benefits package to eligible employees that will allow you to choose the best coverage to meet your family's needs. For details, please review the DAHL Benefits Summary: -w2fta/. How to Apply Take the first step on your new career path! To submit yourself for consideration for this role, simply click the apply button and complete our mobile-friendly online application. Once we've reviewed your application details, a recruiter will reach out to you with next steps! Equal Opportunity Statement As an equal opportunity employer, Dahl Consulting welcomes candidates of all backgrounds and experiences to apply. If this position sounds like the right opportunity for you, we encourage you to take the next step and connect with us. We look forward to meeting you! #LI-MJ1 #LI-Onsite #ZREmployment Type: CONTRACTOR

\nCompany Description

Our promise is simple. DAHL has proven year after year that we are flexible, consistent and easy to work with, which is why our clients and consultants have stayed with us, and we've continued to grow throughout the years.




Our clients know they can depend on our efforts, as we hold their priorities in high regard. We genuinely care about each and every relationship and promise to work with the utmost of respect, integrity and high energy, as we continually strive to build long-term relationships.

Company Description

Our promise is simple. DAHL has proven year after year that we are flexible, consistent and easy to work with, which is why our clients and consultants have stayed with us, and we've continued to grow throughout the years.\r\n \r\nOur clients know they can depend on our efforts, as we hold their priorities in high regard. We genuinely care about each and every relationship and promise to work with the utmost of respect, integrity and high energy, as we continually strive to build long-term relationships.