Medical Appeals Specialist — NSA/IDR Focus

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

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.