Denials Specialist - (2 PT)

Denials Specialist - Remote

Review denied claims and AI-generated denials recommendations and appeal strategies.

Assess the reasoning quality and persuasiveness of AI-generated appeals across denial types and payers.

Identify cases where AI recommendations diverge from effective denials practices and explain why.

Describe the reasoning patterns behind successful appeals to our product team to improve AI recommendations including how to evaluate appealability, how different arguments work with different payers, how to structure medical necessity appeals vs. authorization appeals, and how to recognize patterns that point to systemic issues.

Critique presentations and provide subject matter expertise to our GTM team.

Minimum 1 year hospital denials/appeals experience.

Working knowledge of payer contracts, medical necessity criteria, and appeal procedural requirements.

Coding certification (CPC/CCS) required for coding-related denials.

Experience with at least one denials management platform preferred (e.g., nThrive, Recondo, MedeAnalytics).

Competitive pay & weekly paychecks

Health, dental, vision, and life insurance

401(k) savings plan

Awards and recognition programs

Benefit eligibility is dependent on employment status.

Amergis, formerly known as Maxim Healthcare Staffing, has served our clients and communities by connecting people to the work that matters since 1988. We provide meaningful opportunities to our extensive network of healthcare and school-based professionals, ready to work in any hospital, government facility, or school. Through partnership and innovation, Amergis creates unmatched staffing experiences to deliver the best workforce solutions. Amergis is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.

"Pursuant to the San Francisco Fair Chance Initiative, Amergis will consider for employment qualified applicants with arrest and conviction records"