Remote Denials & Appeals Specialist

Phothera Phototherapy; Cleveland (OH); Remote; USD 39,000 - 48,000; Full time

Benefits offered by this job

Monthly bonus opportunity

Fully remote work environment

Opportunity to join growing healthcare

Job summary

Phothera is seeking a Denials & Appeals Specialist to own the appeals process for denied and underpaid claims, focusing on medical necessity and payer policy alignment to maximize reimbursement and patient access.

While the role is fully remote, candidates based in or near Beachwood, OH are strongly preferred. This opportunity includes a monthly bonus opportunity and a fully remote work environment within a growing healthcare organization.

Qualifications

• 3+ years in medical billing, reimbursement, denial management, or revenue cycle operations.
• Experience submitting appeals for medical necessity and payer denials.
• Experience with commercial and government payers.
• Proficiency with Excel, Word, and PDF management.
• Ability to work independently in a remote environment.

Responsibilities

• Review, analyze, and prioritize denied or underpaid claims.
• Draft, submit, and manage appeals through resolution.
• Prepare appeals for medical necessity, coverage, and payer denials.
• Monitor payer deadlines and escalation requirements.
• Maintain organized workflows for timely submissions.

Skills

Denied claims ownership

Appeals management

Payer policy knowledge

Remote work

Tools

Excel

Word

PDF management

Job description

Phothera is seeking a Denials & Appeals Specialist to own the appeals process for denied and underpaid claims, focusing on medical necessity and payer policy alignment to maximize reimbursement and patient access.

While the role is fully remote, candidates based in or near Beachwood, OH are strongly preferred. This opportunity includes a monthly bonus opportunity and a fully remote work environment within a growing healthcare organization.