Healthcare Appeals Lead – Denials & Disputes

Aiken Regional Medical Centers; Brentwood (TN); On-site; USD 50,000 - 70,000; Full time

Benefits offered by this job

Sign-on bonus

Excellent Medical, Dental, Vision and

401k plan with company match

Generous Paid Time Off

Job summary

Universal Health Services, Inc. (UHS) via CCS is seeking an Insurance Denials and Appeals Specialist in Brentwood, TN. You will monitor denials, document outcomes in MS4 and MIDAS, and coordinate with HIM and clinicians to build strong appeal cases.

Success requires excellent communication, leadership, and analytical skills to guide appeal strategies in a compliance-driven environment. Collaboration with facility teams and BOC partners is essential.

Qualifications

• High School Diploma or GED required.
• Associate's Degree preferred.
• 1-3 years related work experience required; 3-5 years preferred.
• Excellent verbal and written communication skills required.
• Solid clinical background in substance abuse and/or mental health treatment.
• Familiarity with the utilization process involved in working with health plans.
• Proficient in Microsoft Office; Excel/Word/PowerPoint.

Responsibilities

• Monitors insurance denials by running appropriate reports and documents results in MS4 and MIDAS.
• Manages staff responsible for post-discharge provider authorization disputes and provider take-backs.
• Collaborates with HIM to retrieve charts and facility clinicians to obtain missing information for strong appeals.
• Resolves issues related to appeals across internal departments and external facilities.
• Manages caseload and oversees post-discharge provider authorization disputes and related take-backs.

Skills

Verbal communication

Written communication

Leadership

Data analysis

Collaboration

Education

High School Diploma or GED

Associate's Degree preferred

Tools

Microsoft Office

Job description

Universal Health Services, Inc. (UHS) via CCS is seeking an Insurance Denials and Appeals Specialist in Brentwood, TN. You will monitor denials, document outcomes in MS4 and MIDAS, and coordinate with HIM and clinicians to build strong appeal cases.

Success requires excellent communication, leadership, and analytical skills to guide appeal strategies in a compliance-driven environment. Collaboration with facility teams and BOC partners is essential.