Appeals Specialist
2 days ago
Atlanta
Job DescriptionOverview We are seeking a highly analytical and proactive Revenue Cycle Appeals Specialist to join our team. This role is ideal for someone with strong experience in appeals, denials, and insurance follow-up within the healthcare revenue cycle. You’ll work in a dynamic environment where priorities shift based on team progress toward monthly goals, balancing quality work with client satisfaction. A Typical Day Includes:🔍 1. Heavy Research (Audit Analysis) • Assigned audits may vary in volume and scope., • Conduct horizontal audits (single payer, priced accounts) to identify true underpayments., • Perform vertical audits (multiple payers, same denial reason) to extract potential underpayments., • Use root cause analysis to determine next steps.📤 2. Rebilling & Appeals Submission, • Focus on claims ready for appeal—already vetted and prioritized., • Write appeal letters, make calls to determine submission pathways, and submit client requests., • Generate and submit actual rebills to payers.📞 3. Follow-Up & Strategic Review, • Make outbound calls on previously submitted appeals., • Conduct in-depth reviews of denial letters to determine escalation or next steps., • Requires high-level decision-making and problem-solving.Key Responsibilities, • Communicate effectively via phone and email to resolve claim issues., • Determine reasons for denials and appropriate appeal pathways., • Escalate claims when necessary and recommend strategic actions., • Collaborate with analysts to identify trends and align priorities with team goals., • Maintain balance between quality work and meeting deadlines to ensure client satisfaction.Tools & Systems, • Work within client EHR systems such as Epic, Cerner, and others., • Use CMD, Egnyte, and other credentialing and billing platforms.Required Skills, • Revenue cycle appeal and denial resolution, • Insurance follow-up and claims audit, • Appeals letter writing and submission, • EMR/EHR experience (Epic, Cerner preferred), • High school diploma or GED, • Minimum 1 year of appeals-specific RCM experience, • Ability to write payer appeals and perform root cause analysis, • Background in third-party vendors #westpriority25 Pay and Benefits The pay range for this position is $23.00 - $25.00/hr. 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 17, 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.