Appeals Analyst

The role

The Appeals Analyst will investigate denied claims and document investigations to effect reimbursement for denied services. This role involves researching clinical policies, contracts, and regulations to guide claim denial research.

What you will do

• Resolve claims by reviewing documentation and calculating benefits due
• Initiate payment or compose appeal letters
• Guide resolution of non-routine claims
• Audit claims to ensure appropriate payment
• Maneuver through multiple facility patient accounting systems
• Prepare reports by securing analytical information
• Analyze claims to determine validity of denial or recovery options
• Draft detailed and convincing correspondence for reimbursement
• Develop relationships with insurance carriers, patients, attorneys, and employers
• Conduct research to build reimbursement arguments

Required qualifications

• High school diploma
• 2-4 years of experience in appeal and claim processing
• Verbal and written communication
• Customer service
• Analytical skills
• MS Office Suite
• Negotiation, problem recognition, and resolution skills
• Ability to multi-task

Nice to have

• Associate's degree or higher

Benefits

• Medical/Dental/Vision insurance
• 401K company match
• Flexible Paid Time Off
• Paid parental leave
• HSA/FSA options
• Educational reimbursement program
• Employer-paid EAP & Mental Health services

Before you apply

• Must successfully pass a background check
• Must fall under the same security role with access to sensitive information, proprietary data and PHI
• Do not provide visa sponsorship or immigration support
• Must be authorized to work in the United States on a full-time, permanent basis without the need for current or future sponsorship

About the company

Xsolis is an AI-driven technology company reducing administrative waste in healthcare. It is headquartered in Franklin, TN.