Remote Denials Appeals Specialist

Aspirion; Delray Beach (FL); Híbrido; USD 55.000 - 80.000; Jornada completa

Descripción de la vacante

Aspirion is hiring a Denials Appeals Specialist to join our revenue cycle team in the United States. You will analyze denials, craft high-quality appeal letters, and submit appeals to insurers to maximize reimbursement and reduce aging accounts receivable.

In this role, you will research denial reasons, coordinate with payers and hospital stakeholders, and ensure compliant documentation across service lines. A background in healthcare operations and strong communication skills are essential.

Formación

• Bachelor’s degree preferred or equivalent combination of education and experience.
• Experience in revenue cycle management or healthcare operations.
• Experience in insurance follow-up, denials, or appeals.
• Familiarity with insurance carriers and payer guidelines.
• Experience working in a productivity and quality metrics-driven environment.
• Remote work experience in a structured environment.
• Experience with EMR systems such as Epic or similar platforms.

Responsabilidades

• Review denied claims and conduct research to identify root cause and appropriate appeal strategy.
• Prepare and submit electronic and written appeals to insurance carriers.
• Conduct follow-up with third-party payers to obtain claim status and support resolution.
• Investigate insurance benefits, eligibility, and claim information across multiple service lines.
• Resolve accounts accurately and efficiently to maximize reimbursement.
• Research and verify billing adjustments, contractual terms, and administrative corrections.
• Communicate with insurance carriers, hospitals, VA facilities, patients, and internal stakeholders to resolve claims.
• Maintain accurate documentation of claim actions, appeal submissions, and outcomes.
• Identify contractual and administrative adjustments and take appropriate action.
• Work independently and collaboratively to achieve productivity and quality goals.
• Follow organizational policies, payer guidelines, and regulatory requirements including HIPAA.
• Cross-train across service lines and support additional operational needs as assigned.
• Access hospital EMRs and payer portals to retrieve clinical documentation, verify claim details, and support the development of comprehensive appeal submissions.

Conocimientos

Analytical thinking

Written communication

Verbal communication

Multi-tasking

Organization

Documentation skills

Attention to detail

Independent work

Customer service

Research skills

Educación

High school diploma or equivalent

Bachelor’s degree preferred or equivalent combination of education and experience

Herramientas

EMR systems (Epic or similar)

Descripción del empleo

Aspirion is hiring a Denials Appeals Specialist to join our revenue cycle team in the United States. You will analyze denials, craft high-quality appeal letters, and submit appeals to insurers to maximize reimbursement and reduce aging accounts receivable.

In this role, you will research denial reasons, coordinate with payers and hospital stakeholders, and ensure compliant documentation across service lines. A background in healthcare operations and strong communication skills are essential.