Appeals Analyst (Fully Remote)

Xsolis; United States; Remote; USD 52,000 - 76,000; Full time

Job summary

Xsolis is seeking an Appeals Analyst to investigate denied claims, document findings, and pursue reimbursement for services denied. The role supports healthcare payers and providers through rigorous claim reviews and policy-based research.

You will work remotely with training at home offices in Tennessee, require 2–4 years of appeal experience, and bring strong communication, negotiation, and analytical skills to identify recovery opportunities.

Qualifications

• High school diploma required; Associate's degree or higher preferred.
• 2–4 years of experience in appeal and claim processing.
• Strong verbal and written communication, customer service, analytical, and negotiation skills.
• Remote role with travel to home offices in TN for training.
• Minimal physical risks, mostly sedentary work with occasional walking or standing.

Responsibilities

• Investigates denied claims, documents investigation, and works to effect reimbursement for denied services.
• Researches denial guidance using clinical policies, contracts, and regulations.
• Resolves claims by reviewing supporting documentation, calculating benefits, initiating payment, and composing appeal letters.
• Analyzes claims to determine validity of denial/recovery options and drafts detailed correspondence.
• Identifies trends from client inventories and formulates recovery resolutions.

Skills

Analytical skills

Negotiation

Communication

Customer service

Research

Education

High school diploma

Associate's degree

Job description

• The Appeals Analyst investigates denied claims, documents investigation, and works to effect reimbursement for denied services.
• Requires strong understanding of clinical policies, contracts, and regulations to guide research into claim denials.
• Resolve claims by reviewing supporting documentation, calculating benefits, initiating payment, and composing appeal letters.
• Analyze claims to determine validity of denial/recovery options and draft detailed correspondence to effect reimbursement.
• Work individually and within a team to identify trends from client inventories and formulate recovery resolutions.

Qualifications:

• High school diploma required; Associate's degree or higher preferred.
• 2-4 years of experience in appeal and claim processing.
• Strong verbal and written communication, customer service, analytical, and negotiation skills.
• Remote role with travel to home offices in TN for training.
• Minimal physical risks, mostly sedentary work with occasional walking or standing.

Xsolis

Xsolis is an AI-driven technology company reducing administrative waste in healthcare by enabling smarter collaboration between providers and payers. Recognized on the Inc. 5000 and Deloitte Technology Fast 500 lists, it is one of the fastest-growing privately-held companies in North America with a passionate, fast-moving culture.