Appeals Analyst: Underpayments & Denials Specialist

sharp; San Diego (CA); On-site; USD 36,000 - 51,000; Full time

Job summary

Sharp HealthCare in San Diego is seeking a billing and accounts management professional to appeal underpayments and manage payer issues within a multi-specialty medical group. The role emphasizes analytics, accurate rate loading, and timely appeals.

The candidate will handle underpayment trends, coordinate with payors, and maintain standardized letters while ensuring compliance with evolving regulations. Weekend work is not required; flexible start times are noted for the role.

Qualifications

• H.S. diploma or equivalent required.
• 5 years billing and 4 years accounts management in a multi-specialty medical group.
• Knowledge of benefits, managed care, and payer reimbursement procedures.

Responsibilities

• File appeals/PDRs on underpaid/denied claims and train staff.
• Analyze billing data and trends to improve revenue.
• Review payor EOBs, contracts, and payer websites to support appeals.
• Communicate with management on denial trends and actions.
• Ensure accurate quarterly, monthly, and yearly insurance rate data.

Skills

Analytical skills

Attention to detail

Communication

Team player

MS Excel

Medical terminology

Education

H.S. Diploma or Equivalent

Bachelor's Degree in finance, business or economics

Tools

MS Excel

Job description

Sharp HealthCare in San Diego is seeking a billing and accounts management professional to appeal underpayments and manage payer issues within a multi-specialty medical group. The role emphasizes analytics, accurate rate loading, and timely appeals.

The candidate will handle underpayment trends, coordinate with payors, and maintain standardized letters while ensuring compliance with evolving regulations. Weekend work is not required; flexible start times are noted for the role.