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Appeals Associate Jobs (NOW HIRING)

McLaren

Appeals Audit Specialist

Grand Blanc, MI · On-site

Responsible for timely and accurate processing, follow-up, and appeal of audits and denial activity ... (LPN), hospital biller, or associate degree. * 5 years' health care experience Preferred:

MedReview

Appeals Specialist II

Manhattan, NY · On-site +1

$50K - $55K/yr

The Appeals Specialist level II performs research, investigation, and analysis of appeals ... Associates Degree. Additional years of related experience may be used in place of education ...

Hughston Clinic

Appeals Analyst Full Time

Columbus, GA · On-site

Batches appeals, when applicable, by payer or network, by CPT/HCPCS code combination, by error type ... Associates degree or higher Special Qualifications Required: * Up-to-date coding certification ...

Hughston Clinic

Appeals Analyst Full Time

Columbus, GA · On-site

Batches appeals, when applicable, by payer or network, by CPT/HCPCS code combination, by error type ... Associates degree or higher Special Qualifications Required: * Up-to-date coding certification ...

UHS

APPEALS SPECIALIST

Brentwood, TN · On-site

Additionally, they manage the denials and appeals process for designated facilities within FRN ... Associate's Degree preferred * 1-3 Years Related work experience required * Excellent verbal and ...

UHS

TEAM LEADER - APPEALS

Las Vegas, NV

Our associates can count on competitive salaries, top-tier medical, dental, and retirement benefits, career training, and support for continued professional development. The Appeals Team Lead ...

UHS

TEAM LEADER - APPEALS

Las Vegas, NV · On-site

Our associates can count on competitive salaries, top-tier medical, dental, and retirement benefits, career training, and support for continued professional development. The Appeals Team Lead ...

UHS

TEAM LEADER - APPEALS

Las Vegas, NV · On-site

Our associates can count on competitive salaries, top-tier medical, dental, and retirement benefits, career training, and support for continued professional development. The Appeals Team Lead ...

MedReview

Appeals Specialist II

Manhattan, NY · Remote

The Appeals Specialist level II performs research, investigation, and analysis of appeals ... Associates Degree. Additional years of related experience may be used in place of education ...

Lancesoft

Grievance & Appeals Nurse

Rancho Cucamonga, CA · On-site

$30.72/hr

Grievance & Appeals Nurse Pay Rate: $30.72/hr on W2 Work location: Rancho Cucamonga, CA 91730 This ... Associate s degree from an accredited institution preferred * Minimum possession of an active ...

Ourhrconnect

Analyst, Appeals

Carolina, RI · On-site +1

Associate's in a job related field Degree Equivalency : Graduate of Accredited School of Nursing ... Experience in medical claims processing, appeals, or coding strongly preferred * Medicare Part B ...

Posted today

UHS

TEAM LEADER - APPEALS

Las Vegas, NV · On-site

$25.85 - $38.77/hr

Our associates can count on competitive salaries, top-tier medical, dental, and retirement benefits, career training, and support for continued professional development. The Appeals Team Lead ...

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Appeals Associate information

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$46K

$108.2K

$172.5K

How much do appeals associate jobs pay per year?

As of Jul 22, 2026, the average yearly pay for appeals associate in the United States is $108,160.00, according to ZipRecruiter salary data. Most workers in this role earn between $80,000.00 and $130,000.00 per year, depending on experience, location, and employer.

What skills do you need to be an appeals specialist?

Appeals specialists need strong communication and analytical skills to review cases and explain decisions clearly. Attention to detail, problem-solving abilities, and familiarity with relevant policies or software are also important. Often, a background in customer service or related fields enhances effectiveness in this role.

What healthcare jobs pay over $100k per year?

Appeals Associates typically do not earn over $100,000 annually, as this salary level is more common in higher-level healthcare roles such as healthcare administrators, physicians, surgeons, or specialized practitioners. These positions often require advanced degrees, certifications, and extensive experience. Salaries vary based on location, experience, and employer size.

What are some common challenges Appeals Associates face when reviewing complex cases, and how can they be addressed?

Appeals Associates often encounter cases with incomplete documentation or ambiguous information, which can make it challenging to reach timely and accurate decisions. To address this, they must communicate effectively with internal teams and external parties to gather missing details and clarify uncertainties. Staying up-to-date with changing regulations and organizational policies is also crucial, as appeals often involve nuanced compliance requirements. Collaboration and continuous learning are key to overcoming these challenges and ensuring fair outcomes.

What does an appeals associate do?

An appeals associate reviews and processes appeals related to denied claims, benefits, or decisions within an organization. They analyze case details, gather supporting documentation, and communicate with clients or stakeholders to resolve disputes efficiently. Strong attention to detail and knowledge of relevant policies or regulations are essential for this role.

What is an appeals representative associate?

An appeals representative associate is a professional who reviews and processes appeals related to claims or decisions, often in insurance, healthcare, or government agencies. They evaluate documentation, communicate with claimants, and ensure compliance with policies, typically requiring strong communication skills and knowledge of relevant regulations.

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

To thrive as an Appeals Associate, you need strong analytical abilities, attention to detail, and a solid understanding of claims processing or legal documentation, often supported by a degree in a related field. Familiarity with case management systems, claims processing software, and regulatory compliance tools is typically required. Excellent written communication, organization, and problem-solving skills are essential soft skills for effectively managing appeals and collaborating with stakeholders. These competencies ensure accurate resolution of appeals, compliance with regulations, and efficient workflow within the organization.

What is the difference between Appeals Associate vs Claims Processor?

CriteriaAppeals AssociateClaims Processor
Required CredentialsHigh school diploma or equivalent; sometimes an associate degree; knowledge of insurance policiesHigh school diploma or equivalent; familiarity with claims processing systems
Work EnvironmentOffice setting, often in insurance or healthcare companiesOffice or remote, handling claims in insurance or healthcare sectors
Employer & Industry UsageInsurance companies, healthcare providers, government agenciesInsurance companies, healthcare organizations, third-party administrators
Common Search & Comparison IntentUnderstanding roles in appeals and claims processesDifferences in claims handling and processing tasks

Appeals Associates focus on reviewing and resolving denied claims or appeals, requiring knowledge of policies and customer communication. Claims Processors handle the initial processing of claims, verifying information and entering data. Both roles are vital in insurance and healthcare industries but differ in their specific responsibilities and stages of claims management.

What cities are hiring for Appeals Associate jobs? Cities with the most Appeals Associate job openings:
What are the most commonly searched types of Appeals jobs? The most popular types of Appeals jobs are:
What states have the most Appeals Associate jobs? States with the most job openings for Appeals Associate jobs include:
Appeals Associate jobs near you

Denials Appeals Specialist

Xtensys Connected Health Solutions

Ithaca, NY • Remote

$24 - $28/hr

Full-time

Posted 19 days ago

Job description

Who We Are

Xtensys is a rapidly growing managed service provider delivering innovative technology solutions to health systems, beginning in New York and expanding nationwide. Owned by two industry leaders with a strong focus on advancing rural and community healthcare, Xtensys is executing several major initiatives and scaling quickly. With a team of more than 500 professionals, we are building a people-centered culture rooted in collaboration, innovation, and strategic thinking.

We are seeking an experienced Denials Appeals Specialist to support our continued growth and commitment to deliver exceptional client outcomes.

Why Join Us?

Mission-Driven Work: You are the "bridge" ensuring technology serves health systems and their patients when they need it most.

Autonomy & Ownership: We trust you. You’ll lead projects, define success, and manage complexities with total support.

A Culture of Innovation: Have a fresh perspective? We want it. We encourage risk-taking and continuous improvement.

Continuous Growth: We fuel your "restless curiosity" with opportunities to expand your skillset and mentor others.

The Role:

Your Mission: As our next Denials Appeals Specialist, you will be focusing on the administration and coordination of denial reviews and appeal management. This role involves evaluating authorization denials, claims recovery, and conducting denial root cause analyses. Collaboration with all departments is essential to ensure a comprehensive denial management process that addresses all revenue cycle factors contributing to denials.

What You’ll Do Day-to-Day:

Denial Recovery: Make preliminary determinations on whether a denial can be recovered and assess the need for additional appeal submissions.

Appeal Preparation: Research and compile appeal files for authorization, low dollar medical necessity, and plan limitation denials.

Root Cause Analysis: Analyze denials to identify underlying causes and contributing factors.

Denial Resolution: Resolve authorization and low dollar medical necessity denials by reviewing payer guidelines, writing appeals, and submitting necessary documentation.

Error Identification: Identify coding, billing, or reimbursement errors related to denials or aging claims for escalation to the Manager of Denials.

Financial Evaluation: Assess denied dollars against expected reimbursements to identify discrepancies.

Benefit Review: Address denials requiring benefit review, including drafting appeals and preparing responses.

Tracking and Trends: Monitor denial issues for escalation to leadership, supporting process improvement initiatives.

Special Projects: Participate in additional projects as assigned.

Who You Are & What You’ll Bring

Proven Track Record:

Strong collaboration skills to work effectively in team settings or independently.

Proactive problem-solving abilities to anticipate obstacles and propose solutions.

Excellent investigative and analytical skills.

Professional written and verbal communication skills.

Exceptional attention to detail and ability to prioritize tasks for accuracy and timeliness.

Adaptability to respond swiftly to change.

Ability to build and maintain effective relationships across the organization.

Motivation to support the ongoing development of Denial Management.

Detail-oriented and proactive individual who can navigate complex processes and contribute to the overall effectiveness of the revenue cycle team.

Proficiency in medical terminology, with working knowledge of ICD-10, CPT, and HCPCS codes.

Education/Certifications:

Associate’s degree in Healthcare or equivalent experience preferred.

In the absence of an Associate’s degree, a high school diploma (or equivalent) with 5 years of revenue cycle experience is required.

Technical Savvy:

Experience with Microsoft Office Suite (Word and Excel).

Experience with Epic preferred

Travel Requirements: No travel required

Physical Readiness: Capability for sedentary work, including sitting for long periods and occasionally exerting up to 10 pounds of force.

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