Claims Analyst

Appeals Negotiator

Location: Tempe, AZ (Onsite)

Job Type: Direct Hire

Schedule: Monday–Friday, 7:00 AM – 4:00 PM (Flexible)

Compensation: $54,000 – $75,000 annually DOE

Bonus Opportunity: $7,500 Sign-On Bonus + Quarterly Performance Bonuses

Join a Growing Team

We are seeking an experienced Appeals Negotiator to join a highly successful Patient Financial Services team in Tempe, Arizona. This position is ideal for a healthcare revenue cycle professional who thrives in complex payer negotiations, appeals management, denial resolution, and reimbursement optimization.

The Appeals Negotiator is responsible for maximizing reimbursement from contracted and non-contracted payers by researching, documenting, negotiating, and pursuing underpayments and denied claims. This role requires exceptional analytical skills, professional writing abilities, and a deep understanding of healthcare reimbursement regulations and compliance requirements.

Key Responsibilities

• Investigate and resolve underpaid and denied healthcare claims.
• Draft detailed, compelling appeal letters and supporting documentation to secure appropriate reimbursement.
• Negotiate with commercial and non-contracted payers regarding claim disputes and reimbursement discrepancies.
• Review denials related to:
• Medical necessity
• Usual and customary payment disputes
• Transport destination disputes
• Ground-level payment reductions
• Other complex reimbursement issues
• Research federal and state regulations, payer policies, statutes, and regulatory requirements to support appeals.
• Maintain strong working relationships with insurance payers and reimbursement partners.
• Review contracts and reimbursement methodologies to identify collection opportunities.
• Analyze patient accounts and revenue cycle data to identify trends and process improvement opportunities.
• Collaborate with Patient Financial Services leadership on denial management and reimbursement strategies.
• Ensure compliance with reimbursement policies, government regulations, and payer requirements.
• Maintain accurate documentation and account records.

Required Qualifications

• High School Diploma or GED required.
• 5+ years of healthcare billing experience.
• 3+ years of appeals writing and payer negotiation experience.
• Experience with commercial and non-contracted payer negotiations.
• Strong understanding of healthcare revenue cycle operations and reimbursement processes.
• Experience researching statutes, contracts, payer policies, and regulatory requirements.
• Proven ability to write professional, persuasive appeal letters.
• Knowledge of:
• Patient account systems
• Revenue management processes
• Healthcare billing workflows
• Denial management
• Collections
• Strong analytical, organizational, and problem-solving skills.
• Excellent verbal and written communication skills.
• Ability to work independently while collaborating effectively with internal teams.

Preferred Qualifications

• Bachelor's degree preferred.
• Experience in:
• Emergency Medical Services (EMS) billing
• Surgical billing
• Medicare
• Managed Care
• Workers' Compensation

Company Culture & Perks

• Free catered lunches daily
• Quarterly bonus opportunities
• Team events and celebrations
• Business casual dress code
• Jeans and tennis shoes on Fridays
• Collaborative and supportive work environment
• Opportunity to work with a respected healthcare organization focused on quality, service, and operational excellence

Additional Information

• Overtime available as business needs require.
• Training schedule: Monday–Friday, 8:00 AM–5:00 PM for the first two weeks.
• Background requirements include a 10-year criminal background check, OIG screening, and 10-panel drug screen.
• This is a safety-sensitive position.
• Drug screening is required and must be successfully completed regardless of medical marijuana card status.

If you have a strong background in healthcare reimbursement, appeals, denial management, and payer negotiations and are looking for an opportunity to make a meaningful financial impact, we encourage you to apply today.

Benefit offerings: include medical, dental, vision, additional voluntary benefits, 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law;
any other paid leave required by Federal, State, or local law;
and Holiday pay upon meeting eligibility criteria.

Equal Opportunity Employer/Veterans/Disabled

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The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

- The California Fair Chance Act

- Los Angeles City Fair Chance Ordinance

- Los Angeles County Fair Chance Ordinance for Employers

- San Francisco Fair Chance Ordinance