Appeals Specialist – Healthcare Denials & Revenue Support

Community Health Systems, Inc.; Franklin (TN); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Comprehensive Health Coverage

401(k) with matching

Student Loan Support – Up to $10,000

Educational Tuition Assistance

Competitive Pay & Full Benefits

Job summary

Community Health Systems, Inc. is seeking an Appeals Specialist I - Rad Tech to review, analyze, and resolve insurance denials, ensuring accurate reimbursement and regulatory compliance. The role logs denials, provides feedback to facilities, and communicates payer updates to stakeholders.

Collaboration with internal teams supports timely appeal resolution and denial prevention. The position emphasizes adherence to CHS appeal processes, data accuracy, and excellent service to patients and

Qualifications

• Associate Degree or higher in Nursing, Radiologic Technology, or Physical/Occupational Therapy required
• 1-3 years of clinical operations experience in Nursing or Radiologic Technology
• 1-3 years of utilization review and/or case management experience leveraging MCG or InterQual preferred
• 1-3 years of claims processing, healthcare billing, or revenue cycle management preferred

Responsibilities

• Files medical necessity and level of care appeals using guidelines (MCG, InterQual, CMS)
• Monitors clinical appeal processes and provides guidance to related departments
• Tracks and manages clinical denials using current tools and processes
• Identifies patterns and trends in denials and communicates findings to stakeholders
• Maintains documentation regarding payer resources and denial/appeals processes
• Understands and applies CHS Appeal Process for denied claims
• Ensures confidentiality of patient accounts per HIPAA rules
• Documents actions per standards in Artiva, HMS and other systems
• Performs other duties as assigned
• Maintains regular and reliable attendance
• Complies with all policies and standards

Skills

Communication

Billing knowledge

Attention to detail

Time management

Education

Associate Degree or higher in Nursing, Radiologic Technology, or Physical/Occupational Therapy

Tools

Google Suite

Healthcare billing software

Job description

Community Health Systems, Inc. is seeking an Appeals Specialist I - Rad Tech to review, analyze, and resolve insurance denials, ensuring accurate reimbursement and regulatory compliance. The role logs denials, provides feedback to facilities, and communicates payer updates to stakeholders.

Collaboration with internal teams supports timely appeal resolution and denial prevention. The position emphasizes adherence to CHS appeal processes, data accuracy, and excellent service to patients and