Appeals Analyst

Xsolis

. Investigate denied claims with clients and client representatives .

Posted 10/27/2026full-timeRemote • Tennessee • United StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in claims processing and appeals, with strong analytical skills to assess denial validity and recovery options. Proficient in developing relationships with stakeholders and ensuring compliance with clinical policies and regulations.

Highest-signal resume keywords

Claims ProcessingAnalytical SkillsCustomer ServiceNegotiation SkillsClinical Policies Understanding

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims RecoveryAppeal ProcessingDocumentationPayment CalculationReport PreparationTrend AnalysisResearch SkillsAuditing ClaimsMulti-taskingLegal Compliance

Soft Skills

Verbal CommunicationWritten CommunicationProblem RecognitionResolution SkillsRelationship Building

Tools & Technologies

MS Office SuitePatient Accounting Systems

Industry Keywords

Insurance ClaimsReimbursementContractsRegulationsQuality Service

About the role

Key responsibilities & impact

Investigate denied claims with clients and client representatives
Document investigations and actions taken through resolution in a claims recovery system
Resolve claims by reviewing supporting documentation, calculating benefits due, initiating payment, composing appeal letters, guiding resolution of non-routine claims, and auditing claims for appropriate payment
Maneuver through multiple facility patient accounting systems
Prepare reports using analytical information
Analyze claims to determine denial validity and recovery options
Draft detailed and convincing correspondence to effect reimbursement
Develop relationships with insurance carriers, patients, attorneys, and employers to facilitate reimbursement
Conduct research to build strong reimbursement arguments
Research and review clinical policies, contracts, and other materials to aid claims recovery
Work individually and within a team to identify trends and formulate recovery resolutions
Ensure legal compliance with guidelines, contracts, regulations, and the company's business plan
Maintain quality service by following provider and payer service practices and protocols

Requirements

What you’ll need

High school diploma required; Associate's degree or higher preferred
2-4 years of experience in appeal and claim processing
Verbal and written communication
Customer service
Analytical skills
MS Office Suite
Negotiation, problem recognition, and resolution skills
Ability to multi-task
Ability to maneuver through multiple facility patient accounting systems
Strong understanding of clinical policies, contracts, and regulations
Must successfully pass a background check
Must already be authorized to work in the United States on a full-time, permanent basis without current or future sponsorship

Benefits

Comp & perks

Medical/Dental/Vision insurance
401K company match
Flexible Paid Time Off
Paid parental leave
HSA/FSA options
Educational reimbursement program
Employer-paid EAP & Mental Health services