Appeals Analyst

Wollborg Michelson Recruiting; Little Rock (AR); On-site; USD 52,000 - 76,000; Full time

Job summary

Wollborg Michelson Recruiting is seeking an Appeals Analyst to review claims and denial information, determine the appropriate internal reviewer, and draft clear letters related to appeals. This role requires healthcare experience and strong writing skills.

You will work with claims teams, research denials, and communicate professionally about clinical or healthcare situations. A bachelor’s degree is preferred, with five additional years substituting for the degree.

Qualifications

• Healthcare experience required.
• 3+ years in healthcare grievances, appeals, claims processing, claims research, or related customer service.
• Bachelor's degree preferred (additional year substitute possible).
• Five additional years of relevant experience may substitute for the degree.

Responsibilities

• Review claims and denial information.
• Determine internal reviewer or responder for each denial.
• Draft professional letters related to claims and appeals.
• Communicate clearly about clinical or healthcare-related situations.

Skills

Professional writing

Problem solving

Research skills

Insurance claims

MS Word

MS Excel

Education

Bachelor's degree

Tools

Microsoft Word

Microsoft Excel

Job description

Appeals Analyst Job Summary Review claims and denial information, determine the appropriate internal reviewer or responder, and draft clear, professional letters related to claims and appeals.

Responsibilities

• Review claims and denial information.
• Determine who within the organization should review or respond to each denial.
• Draft professional letters related to claims and appeals.
• Communicate clearly and professionally about clinical or healthcare-related situations.

Requirements

• Healthcare experience required.
• At least three years of relevant experience in healthcare grievances, appeals, claims processing, claims research, customer service, or related legal work.
• Claims or appeals experience preferred.
• Bachelor s degree in a related field preferred.

Writing/Drafting Appeal letters

Five additional years of relevant experience may substitute for the degree.

Skill

• Strong professional writing skills.
• Problem-solving and research skills.
• Working knowledge of insurance products, policies, procedures, or claims processing preferred.
• Proficiency with Microsoft Office, particularly Microsoft Word and Excel.

Summary Qualification Healthcare and claims-related experience.Excellent written communication and research abilities.Ability to analyze denials and identify the appropriate response process.Ability to write clear, professional correspondence involving clinical or healthcare matters.

Wollborg Michelson Recruiting is an Equal Opportunity Employer and prohibits discrimination of any kind. We ensure job offers are made based on one s employment experience, skills, and qualifications, regardless of race, gender, ethnic origin, or any other classification protected by law. All applicants must furnish proper identification to prove their legal right to work in the US upon a job offer. We participate in E-Verify to confirm one s right to work in the US. Wollborg Michelson Recruiting does not provide sponsorship for an employment-based visa status.