[Hiring] Appeal Writer - Hospital Billing, Denials @Aspirion

Role Description

The Denials Appeals Specialist is responsible for analyzing, drafting, and submitting high-quality appeal letters for denied claims. This role focuses on analyzing denial reasons, correcting claim errors, and submitting appeals in accordance with payer guidelines and organizational standards.

This position plays a critical role in generating organizational revenue by processing denial claims. Through timely and accurate appeals, this role supports improved cash flow, reduced accounts receivable aging, and minimized revenue leakage.

This role supports key revenue cycle initiatives centered on denial reduction, revenue integrity, and operational efficiency. By identifying denial trends, collaborating with cross-functional stakeholders, and improving appeal success rates, the Appeals Specialist contributes to continuous improvement and overall financial performance.

What you will do

• 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

Qualifications

• High school diploma or equivalent required
• Strong analytical and critical thinking skills with the ability to evaluate denial root causes
• Strong written and verbal communication skills with the ability to draft clear and persuasive appeal letters
• Ability to multi-task and manage competing priorities
• Strong organizational and time management skills
• Effective documentation and follow-up skills
• Ability to research and interpret insurance information and benefits
• Strong attention to detail and accuracy in documentation and appeal preparation
• Active listening and customer service skills
• Ability to work independently in a fast-paced environment
• Reliable attendance and consistent performance
• Ability to learn quickly and adapt to changing priorities

Requirements

• 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 working across multiple service lines
• Demonstrated ability to identify trends and process improvement opportunities
• Experience working with EMR systems such as Epic or similar platforms
• Prior experience in healthcare revenue cycle or denial management environments

Core expectations

• Demonstrate integrity and ethics in day-to-day tasks and decision making
• Operate effectively in the environment and the environment of the work group
• Maintain a focus on self-development and seek out continuous feedback and learning opportunities
• Support Compliance Program by adhering to policies and procedures pertaining to HIPAA, GLBA, FCRA, and other laws applicable to business practices
• Become familiar with Code of Ethics, attending training as required
• Notify management when there is a compliance concern or incident
• HIPAA-compliant handling of patient information
• Demonstrable awareness of confidentiality obligations