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Appeals And Denials Jobs (NOW HIRING)

Northwell

Appeals Specialist

Lake Success, NY · On-site

$66K - $108K/yr

Responds to commercial payers, managed care and third party review organizations in managing the appeals/denials process. Supports the review of denial trends and identifies coding issues and ...

Northwell

Appeals Specialist

Lake Success, NY

Responds to commercial payers, managed care and third party review organizations in managing the appeals/denials process. Supports the review of denial trends and identifies coding issues and ...

Northwell Health

Appeals Specialist

Lake Success, NY · On-site

$66K - $108K/yr

Responds to commercial payers, managed care and third party review organizations in managing the appeals/denials process. Supports the review of denial trends and identifies coding issues and ...

West Virginia University Health System

Coordinates and performs appeals writing for RAC, Medicaid RAC, payer and other government denials. Provide process improvement initiatives through route cause analysis. MINIMUM QUALIFICATIONS:

WVU Medicine

Clinical Denials Coord

Morgantown, WV · On-site

Coordinates and performs appeals writing for RAC, Medicaid RAC, payer and other government denials. Provide process improvement initiatives through route cause analysis. MINIMUM QUALIFICATIONS:

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Appeals And Denials information

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$30.5K

$86.5K

$115.5K

How much do appeals and denials jobs pay per year?

As of Aug 2, 2026, the average yearly pay for appeals and denials in the United States is $86,480.00, according to ZipRecruiter salary data. Most workers in this role earn between $66,500.00 and $98,500.00 per year, depending on experience, location, and employer.

What is the difference between Appeals And Denials vs Claims Processor?

AspectAppeals And DenialsClaims Processor
Primary RoleReviewing and contesting denied insurance claimsProcessing and entering insurance claims for payment
Required CredentialsKnowledge of insurance policies, healthcare regulationsBasic insurance and data entry skills
Work EnvironmentHealthcare offices, insurance companiesMedical offices, insurance companies

Appeals And Denials specialists focus on challenging denied claims, requiring detailed knowledge of policies and regulations. Claims Processors handle the initial processing of claims, ensuring accurate data entry and submission. While both roles work within the insurance industry, Appeals And Denials professionals deal with complex disputes, whereas Claims Processors manage routine claim processing tasks.

What are Appeals and Denials in healthcare?

Appeals and Denials refer to the process within healthcare billing and insurance where claims for medical services are either rejected (denied) or challenged (appealed) by providers or patients. Denials occur when an insurance company refuses to pay for a service, often due to issues like lack of coverage, missing documentation, or coding errors. Appeals happen when a provider or patient disagrees with the denial and formally requests a review or reconsideration. This process is crucial for ensuring that providers receive appropriate payment and that patients have access to necessary care. Understanding the appeals and denials process helps reduce lost revenue and improves patient satisfaction.

What are some common challenges faced in an Appeals and Denials Specialist role, and how can they be effectively managed?

Appeals and Denials Specialists often face challenges such as navigating complex insurance policies, meeting tight deadlines for appeal submissions, and ensuring thorough documentation for each case. Staying organized and detail-oriented is crucial, as missing a deadline or required document can result in lost reimbursement. Effective communication with insurance companies, healthcare providers, and internal teams helps streamline the process and resolve denials more efficiently. Leveraging standardized templates and keeping up with regulatory changes also contribute to success in this role.

What are the key skills and qualifications needed to thrive as an Appeals and Denials Specialist, and why are they important?

To thrive as an Appeals and Denials Specialist, you need a strong understanding of medical billing, insurance policies, and claims processing, typically supported by experience in healthcare administration or a related field. Familiarity with claims management software, electronic health records (EHRs), and knowledge of HIPAA regulations are essential technical requirements. Excellent analytical skills, attention to detail, and effective written and verbal communication are soft skills that set top performers apart. These skills and qualifications are crucial for successfully resolving complex claims issues, maximizing reimbursement, and ensuring compliance with payer requirements.
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What cities are hiring for Appeals And Denials jobs? Cities with the most Appeals And Denials job openings:
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What job categories do people searching Appeals And Denials jobs look for? The top searched job categories for Appeals And Denials jobs are:
Appeals And Denials jobs near you
Infographic showing various Appeals And Denials job openings in the United States as of July 2026, with employment types broken down into 2% As Needed, 92% Full Time, 4% Part Time, and 2% Contract. Highlights an 80% In-person, 9% Hybrid, and 11% Remote job distribution, with an average salary of $86,480 per year, or $41.6 per hour.

Medical Appeals & Denials Specialist

Healthcare Support Staffing

Clearwater, FL

$14 - $16/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 18 days ago

Job description

Company Description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

They are handling the full cycle process of figuring out WHY a CLAIM was DENIED and from there RESEARCHING and figuring out WHAT needs to be done to get it into the appeals process

They are dealing 99% of the time with insurance companies and Medicare/Medicaid

HEAVY phones

They do all the work until the actually appeals letter is sent out. When that letter is sent out another department takes over.

They will work off of 6 proprietary systems, each unique to the client (hospital system) they are working with. Since they have an influx of new hospitals as clients this is what they will work on the majority of their days.

Critical thinking skills are very important


Qualifications

Must have Claims, Appeals and Denials experience of 2 years coming from hospital and/or physician background

Must have billing knowledge, as well as Commercial Insurance, Medicare, Medicaid, ICD 10, CPT Codes and understand the various billing forms, such as CMS 1500 and HCFA 1500 (types of billing forms used for hospital/physicain billing)

Must have worked the FULL CLAIM, not just entered a piece of the pie into the system (things they should know or have worked on: Why was the claim denied? Was it due to the DOB (date of birth) being entered in incorrectly? Or was medical necessity not sufficient?) These are examples of things they should be use to researching and then coming to a resolution.

Must be very organized

Must be able to work at a very fast pace

Must not be scatter brained

Must be able to work off many different web applications and dual screens

Must be very proficient with Excel spreadsheets as that is what they are given their work off of (sorting, filtering, etc.)


Additional Information

Hours for this Position:

M- F 730-4p or 8a-430p

Advantages of this Opportunity: 

Competitive salary $14.00- 16.00 per hr  

Excellent Medical benefits Offered, Medical, Dental, Vision, 401k, and PTO 

Growth potential 

Fun and positive work environment


Healthcare Support logo

About Healthcare Support

Sourced by ZipRecruiter

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Maitland, FL, US

Year founded

2003

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