Appeals Specialist

Job Description

Legal Appeals Research Specialist

Job Summary

Supports the organization and coordination of legal appeals and complaints by preparing reports, conducting research, gathering documents, handling inquiries, and coordinating activities for professional staff.

Responsibilities

• Process and research medical claims, appeals, and complaints.
• Conduct intake and gather claims related to denials.
• Collect, review, and organize supporting documentation.
• Prepare reports and coordinate appeal-related activities.
• Respond to inquiries regarding appeal status.
• Communicate professionally with providers and internal staff.
• Maintain confidentiality and ensure accurate records.

Requirements

• High school diploma or equivalent.
• At least three years of experience in claims processing, claims research, or customer service.
• Familiarity with CPT and ICD-10 coding.
• Knowledge of medical terminology;healthcare experience is preferred.
• Strong verbal and written communication skills.

Skill

• Microsoft Office Suite
• Medical claims processing
• Research and document management
• Professional phone communication
• Interpersonal communication
• Multitasking and organization
• Attention to detail
• Problem-solving
• Professional judgment
• Confidentiality

Summary Qualification

• Organized and detail-oriented with the ability to manage multiple tasks accurately.
• Strong communication and customer service skills.
• Comfortable working with claims, coding, medical terminology, and appeal documentation.
• Open to candidates with relevant healthcare, claims, research, or customer service experience.

Wollborg Michelson Recruiting is an Equal Opportunity Employer and prohibits discrimination of any kind. We ensure job offers are made based of one s employment experience, skills, and qualifications, regardless of race, gender, ethnic origin, or any other classification protected by law. All applicants must furnish proper identification to prove their legal right to work in the US upon a job offer. We participate in E-Verify to confirm one s right to work in the US. Wollborg Michelson Recruiting does not provide sponsorship for an employment-based visa status.