DENIALS - Appeals Specialist

The Intersect Group

Columbus, GA

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JOB DETAILS

SKILLS

Analysis Skills, Cash Flow, Communication Skills, Continuous Improvement, Contract Management, Detail Oriented, Documentation, Electronic Medical Records, Epic Systems, Health Informatics, Healthcare, Healthcare Providers, High School Diploma, Hospital, Insurance, Insurance Claims, Organizational Skills, Performance Tuning/Optimization, Persuasion Skills, Process Improvement, Reconciliation, Reimbursement, Root Cause Analysis, Strategic Planning, Team Player, Time Management, Trend Analysis, Writing Skills

LOCATION

Columbus, GA

POSTED

1 day ago

Company Overview
Our client is a healthcare services organization focused on optimizing revenue cycle performance for hospitals and provider networks. They partner with healthcare systems to navigate complex payer requirements, reduce denials, and improve reimbursement outcomes. With a strong emphasis on accuracy, compliance, and operational excellence, they foster a collaborative environment dedicated to continuous improvement and measurable financial impact.

Role Summary
The Denials Appeals Specialist is responsible for driving resolution of denied claims through detailed analysis, strategic appeal development, and consistent follow-up with payers. This role directly contributes to improving cash flow, reducing revenue leakage, and strengthening overall revenue cycle performance.

In this position, you will analyze denial root causes, prepare compelling appeal documentation, and work across multiple systems to ensure accurate and timely submissions. You will collaborate with internal stakeholders and external partners to resolve accounts, identify denial trends, and support initiatives that enhance reimbursement success and operational efficiency.

Key Responsibilities
Review denied claims to determine root cause and define appropriate appeal strategy
Prepare and submit detailed written and electronic appeals in alignment with payer guidelines
Conduct follow-up with insurance carriers to track claim status and drive resolution
Investigate insurance coverage, eligibility, and claim details across multiple service lines
Document all claim activity, appeal submissions, and outcomes accurately in internal systems
Identify and resolve billing discrepancies, contractual adjustments, and administrative errors
Communicate effectively with payers, healthcare providers, and internal teams to resolve claims
Analyze denial trends and contribute to process improvement initiatives

Key Requirements
1 to 4 years of experience in healthcare revenue cycle, denials, or appeals management
High School Diploma or GED required, Bachelors degree preferred
Strong understanding of insurance claims, payer guidelines, and denial management processes
Experience working with EMR systems such as Epic and payer portals
Proven ability to analyze denial root causes and develop effective appeal strategies
Strong written communication skills with the ability to draft clear, persuasive appeals
High attention to detail with strong organizational and time management skills
Ability to work independently while collaborating effectively in a team environment

About the Company

The Intersect Group

The Intersect Group is a different and better business partner. We create unparalleled value for our clients by combining industry-leading Consulting capabilities with comprehensive Staffing and recruitment services. Clients trust us to deliver results based on our deep expertise and proven resources within finance, accounting, and information technology. Through our flexible delivery approach, you get the right solution, at the right time to accelerate your success and achieve all of your mission-critical objectives.

COMPANY SIZE

500 to 999 employees

INDUSTRY

Staffing/Employment Agencies

FOUNDED

2006

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