Appeals Specialist (Medical Billing) - Remote Eligible

EverStaff, LLC; Middleburg Heights (OH); Hybrid; USD 27,000 - 29,000; Full time

Benefits offered by this job

Direct Hire

Hybrid schedule

In-office training

Job summary

EverStaff in Middleburg Heights, OH is seeking an Appeals Specialist to manage insurance claim denials and lead the appeals process for proper reimbursement.

The role requires detail orientation, knowledge of medical billing, payer guidelines, and ability to prepare effective appeals; schedule Mon-Fri 8am-5pm with 3 months in office before remote.

Direct hire, salary $19.50–$21.00 per hour, join a team dedicated to compliant, accurate denial resolution and timely documentation.

Qualifications

• High school diploma or GED required.
• Experience in healthcare billing and insurance appeals.
• Strong knowledge of managed care, payer structures, Medicare/Medicaid.
• Proficient in reimbursement and denial resolution.
• Excellent written and verbal communication.
• Ability to manage multiple priorities independently.
• Maintain confidentiality per HIPAA and company policies.

Responsibilities

• Review assigned insurance denials and EOBs to identify appeal opportunities and determine required documentation.
• Analyze case history, payer guidelines, and state regulations to develop effective appeal strategies.
• Obtain necessary patient and/or physician authorizations and medical records in accordance with insurance and regulatory requirements.
• Complete and submit all required appeal forms, ensuring accuracy and completeness.
• Draft professional appeal letters, compile supporting documentation, and submit appeals in a timely manner.
• Coordinate and schedule phone hearings with insurance representatives, patients, and providers as needed.
• Adhere to all established procedures for appeals, including proper documentation and compliance standards.
• Manage assigned worklists to ensure all appeal deadlines are met; expedite issues to management when assistance is needed.
• Monitor and report changes in payer requirements, state regulations, or denial trends to leadership.
• Participate in team meetings by providing updates and insights on cases and outcomes.
• Provide backup support for incoming calls when necessary.
• Assist with special projects and additional tasks as assigned by leadership.

Skills

Healthcare billing

Appeals processing

HIPAA compliance

Attention to detail

Communication skills

Multitasking

Education

High School Diploma or GED

Job description

EverStaff in Middleburg Heights, OH is seeking an Appeals Specialist to manage insurance claim denials and lead the appeals process for proper reimbursement.

The role requires detail orientation, knowledge of medical billing, payer guidelines, and ability to prepare effective appeals; schedule Mon-Fri 8am-5pm with 3 months in office before remote.

Direct hire, salary $19.50–$21.00 per hour, join a team dedicated to compliant, accurate denial resolution and timely documentation.