Appeals Specialist - Fully Remote

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Description

Components of a typical day - time spent in each bucket depends on progress towards the target/goal for the team, and leaders will assign priority in workflow based on progress to goal for the month.

(ex: rebill goal is $500M for the month of Sept. - if they are head of schedule, they will focus on research, if they are behind, they will focus on most high $ rebills to try to collect the most possible)

• heavy research - will be assigned an audit of varying volume of accounts
  
  

will either be a payer that's been priced and they need to research underpayments to determine which ones are truly underpaid (horizontal audit) OR could span multiple payers but extracting potential underpayments that are denied for the same reason (vertical audit)

• rebilling - focus on "out the door" claim appeals that are more ready to go - have already been vetted. take this time to write the appeals, make the phone call to determine where the appeals go, submit client requests. actual re-bill generating work
• follow up - making outbound calls on appeals they've already sent. this is not the simple call - this is a follow up that's been re-routed to the appeals specialist to do in the depth review of the denial letter to determine the best step forward to collect. this still requires a high level of decision making and analytical thinking
  
  

Very heavy phone work - must be very comfortable just picking up the phone to communicate and solve problems

• determine why claims are denied
• determine where to send appeals
• determine whether a claim needs to be escalated
  
  

High degree of ownership - able to make strategic recommendations about the nature of an account, help the analyst find trends, reach team goals and align priorities effectively

This team focuses on quality over quantity but also customer satisfaction so it's a balance of quality work with meeting deadlines and goals to serve their clients

Skills

revenue cycle appeal, revenue cycle specialist, denials specialist, appeals specialist, insurance follow up, root cause analysis, EHR, EMR, EPIC, Cerner, medical billing, claims audit, appeals process, appeals letter, denials, insurance follow ups

Top Skills Details

revenue cycle appeal,revenue cycle specialist,denials specialist,appeals specialist,insurance follow up

Pay and Benefits

The pay range for this position is $23.00 - $25.00/hr.

Requirements

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave)
  
  

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Sep 18, 2025.

h4>About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems And TEKsystems Global Services

We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

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