Appeals Specialist

Adaptive Biotechnologies Corp.

. Review denied claims and determine appropriate appeal strategy based on payer guidelines .

Posted 9/22/2026full-timeRemote • United StatesJuniorMid-Level💰 $23 - $28 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in insurance appeals and denial management, with a strong understanding of payer guidelines and compliance with HIPAA regulations. Proficient in utilizing billing systems and Microsoft Office Suite to track and manage appeal processes effectively.

Highest-signal resume keywords

Insurance Appeals ManagementDenial ManagementBilling Systems ProficiencyExcellent Communication SkillsRegulatory Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Insurance ProcessesAppeal Strategy DevelopmentPayer Guidelines KnowledgeMolecular and Genetic Testing PoliciesDocumentation PreparationClaim ReviewData TrackingProblem-SolvingCritical Thinking

Soft Skills

Detail-OrientedOrganizational SkillsAbility to Work IndependentlyFlexibility

Tools & Technologies

Microsoft Office SuiteBilling Systems

Industry Keywords

HIPAA ComplianceRevenue Cycle OperationsPayer RelationsPrior AuthorizationMedical Billing

About the role

Key responsibilities & impact

Review denied claims and determine appropriate appeal strategy based on payer guidelines
Prepare and submit appeal letters with supporting documentation
Submit appeals through payer-preferred portals, fax, or mail within payer-specific timelines
Track appeal status and maintain accurate billing-system records
Contact insurance companies to confirm receipt and appeal progress
Escalate unresolved appeals or complex cases to management
Stay current on payer policies and appeal requirements for molecular and genetic testing
Ensure appeal activities comply with HIPAA and regulatory standards
Identify denial trends and collaborate with reimbursement teams to reduce future occurrences
Collaborate with prior authorization, billing, and payer relations teams
Communicate with providers when additional clinical information is required
Perform other duties as assigned

Requirements

What you’ll need

High school diploma required
2 years in insurance appeals, medical billing, or revenue cycle operations
Strong understanding of insurance processes and denial management
Excellent written and verbal communication skills
Proficiency in billing systems and Microsoft Office Suite
Detail-oriented and organized
Ability to work independently and manage multiple priorities
Strong problem-solving and critical thinking skills
Flexibility to work out of standard hours when necessary, including nights, weekends, and holidays
Adaptive is not currently sponsoring candidates requiring work authorization support for this position

Benefits

Comp & perks

Equity grant
Bonus eligible
Affirmative Action and Equal Opportunity Employer
Reasonable accommodation support for disabled job seekers