Denials Specialist (Appeals & Revenue Cycle)

Denials Specialist

Insight Global is seeking a fully remote Denials Specialist to support a Healthcare AI client. This is a part-time opportunity working approximately 1020 hours/week where candidates will leverage their denials and appeals expertise to evaluate and improve AI-driven denial resolution strategies. This role is highly analytical and requires a strong understanding of payer requirements, denial root causes, and effective appeal strategies across multiple payer types. Laptop and equipment will be provided. Shift Times: Flexible scheduling within Monday-Friday, 9am-8pm PST (can't work weekends) (must be available 10-20 hours/week from 9am-8pm PST // ideal for individuals seeking additional income) Duration: 3-month contract (potential to extend)

Responsibilities:

• Review denied claims and evaluate AI-generated denial analysis and appeal recommendations
• Assess the quality, logic, and persuasiveness of AI-generated appeal strategies across various denial types (medical necessity, authorization, coding, technical, etc.)
• Identify discrepancies where AI recommendations diverge from effective real-world denial management practices
• Analyze and explain successful appeal strategies, including payer-specific nuances and documentation requirements
• Evaluate appealability and determine optimal approach based on denial type, payer guidelines, and supporting documentation
• Provide detailed reasoning behind appeal strategies to help improve AI decision-making models
• Identify patterns and trends across denials to highlight systemic issues impacting reimbursement
• Partner with product and GTM teams to critique presentations and provide subject matter expertise on denial workflows and payer behavior