Remote Clinical Denials & Appeals Specialist

Firstsource Solutions Ltd; United States; On-site; USD 52,000 - 78,000; Full time

Benefits offered by this job

Medical coverage

Vision coverage

Dental coverage

401K

Paid time off

Job summary

Firstsource Solutions Ltd is seeking a Clinical Denials Specialist to manage denial appeals across referrals, authorizations, and medical necessity in a remote setting. Strong written communication and HIPAA adherence are required. You will research payer denials, write professional appeals, and monitor outcomes while ensuring timely submissions.

EHR experience and payer policy knowledge are preferred. Schedule is Monday to Friday, 8:00 AM–4:30 PM EST, with opportunities to improve processes and

Qualifications

• Research payer denials (referral, authorization, medical necessity, non-covered).
• Write professional appeals per client and payer policies.
• Prepare management reports and identify trends.
• Review utilization review and coverage guidelines for multiple payers.
• Identify process improvement opportunities.
• Monitor denial and appeal outcomes and report findings to management.
• Ensure compliance with HIPAA and payer regulations.

Responsibilities

• Research assigned payer denials and prepare professional appeal letters.
• Independently write and submit appeals per client/payer policies.
• Prepare reports for management review and identify trends.
• Review utilization review and coverage guidelines for multiple payers.
• Identify process improvement opportunities and monitor outcomes.
• Maintain confidentiality and HIPAA compliance in all tasks.
• Collaborate with management and other teams as needed.

Skills

Payer policy knowledge

HIPAA compliance

Written communication

Denials management

Education

Associate’s Degree in business or healthcare

RN certification

Tools

Epic

Cerner

Meditech

Job description

Firstsource Solutions Ltd is seeking a Clinical Denials Specialist to manage denial appeals across referrals, authorizations, and medical necessity in a remote setting. Strong written communication and HIPAA adherence are required. You will research payer denials, write professional appeals, and monitor outcomes while ensuring timely submissions.

EHR experience and payer policy knowledge are preferred. Schedule is Monday to Friday, 8:00 AM–4:30 PM EST, with opportunities to improve processes and