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