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.

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
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

Appeal Writer – Hospital Billing, Denials

Key skills