Medical Appeals Specialist

Gosnaphop; Addison (TX); On-site; USD 66,125,000 - 82,656,000; Full time

Benefits offered by this job

Medical

Dental

Vision

Job summary

Addison Group is seeking three Appeals Specialists to join its Revenue Cycle team in Addison, TX. This on-site role focuses on NSA disputes, IDR/arbitration, and out-of-network reimbursement to maximize payor payments.

Ideal candidates have 2–3+ years in medical revenue cycle appeals, with a proven history writing appeals and overturning denials. Direct arbitration experience is preferred but not required; equally valued are strong medical appeals backgrounds.

Qualifications

• 2–3+ years of medical Revenue Cycle appeals, arbitration, denials, or reimbursement experience.
• Experience personally researching and writing medical appeals.
• Demonstrated success overturning denials or recovering additional reimbursement.
• Strong understanding of medical claims and payer reimbursement.
• Ability to identify denial and underpayment trends.
• Strong research, analytical, and written communication skills.
• Ability to independently investigate a claim and build a compelling case for reimbursement.

Responsibilities

• Manage healthcare arbitration and reimbursement dispute cases.
• Work No Surprises Act (NSA) and Independent Dispute Resolution (IDR) cases.
• Research denied and underpaid medical claims; review payer reimbursement and identify denial or payment patterns.
• Gather supporting documentation to build arbitration and appeal cases.
• Write detailed appeals and reimbursement arguments.
• Submit cases through appropriate arbitration or dispute resolution channels.
• Communicate with payers regarding reimbursement disputes.
• Track cases through final resolution.
• Identify opportunities to recover additional reimbursement.
• Review case outcomes and favorable resolution trends.
• Assist with out-of-network and other complex reimbursement issues.

Skills

Medical Revenue Cycle

Appeals writing

Denials overturn

Job description

Arbitration Specialist – Medical Billing / Appeals

Location: Addison, TX, fully on site

Pay: $23–$29/hour, based on experience

Schedule: Monday–Friday, flexible daytime schedule

Employment Type: Direct Hire

Benefits: Medical, Dental, Vision

Position Overview

Addison Group is hiring for our client, an established healthcare organization seeking three Appeals Specialists to join its Revenue Cycle team.

This position focuses on No Surprises Act (NSA) disputes, IDR/arbitration, appeals, and out-of-network reimbursement. The Arbitration Specialist will investigate underpaid or denied claims, gather supporting documentation, and develop strong written arguments to maximize reimbursement.

Direct arbitration experience is preferred but not required. We are also interested in experienced Medical Appeals Specialists who have personally written appeals and have a strong track record of successfully overturning denials.

Key Responsibilities

• Manage healthcare arbitration and reimbursement dispute cases
• Work No Surprises Act (NSA) and Independent Dispute Resolution (IDR) cases
• Research denied and underpaid medical claimsReview payer reimbursement and identify denial or payment patterns
• Gather supporting documentation to build arbitration and appeal cases
• Write detailed appeals and reimbursement arguments
• Submit cases through appropriate arbitration or dispute resolution channels
• Communicate with payers regarding reimbursement disputes
• Track cases through final resolution
• Identify opportunities to recover additional reimbursement
• Review case outcomes and favorable resolution trends
• Assist with out-of-network and other complex reimbursement issues

Qualifications

• 2–3+ years of medical Revenue Cycle appeals, arbitration, denials, or reimbursement experience
• Experience personally researching and writing medical appeals
• Demonstrated success overturning denials or recovering additional reimbursement
• Strong understanding of medical claims and payer reimbursement
• Ability to identify denial and underpayment trends
• Strong research, analytical, and written communication skills
• Ability to independently investigate a claim and build a compelling case for reimbursement

Highly Preferred:

• No Surprises Act (NSA) experience
• IDR/IDRE or healthcare arbitration experience
• Out-of-network reimbursement experience
• Experience writing and submitting arbitration cases
• Surgery center or specialty medical billing experience
• Medical subrogation experience
• Payer-side arbitration or appeals experience

Ideal Candidate

We are looking for someone who enjoys digging into complex reimbursement issues and building a case for why a claim should be paid differently.

You do not necessarily need direct arbitration experience if you have a strong medical appeals background. Candidates who can demonstrate a history of writing effective appeals, overturning denials, and achieving favorable reimbursement outcomes are encouraged to apply.

Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.

#HC1