Remote Health Insurance Appeals Specialist

Position Overview

We’re seeking a motivated and knowledgeable Remote Health Insurance Appeals Specialist to help streamline claims appeals and improve reimbursement accuracy. This role is more than administrative—it's a chance to take ownership of appeals processes that directly affect patient satisfaction and financial recovery. You'll bring clarity to complex coverage rules and be the bridge between clinical accuracy and insurer accountability. We value professionals who combine diligence with empathy and understand the real-world implications of denied claims. As a fully remote position, you’ll be empowered to operate independently while remaining fully integrated with a collaborative, mission-driven team. If you have a firm grasp of insurance policies, remote workflows, and healthcare regulations, this role allows you to work independently while supporting fair outcomes for patients and providers.

You’ll review complex health insurance denials, prepare effective appeals, and collaborate across teams to resolve billing issues. With our fully virtual setup, you’ll gain the freedom to manage your schedule while making a measurable impact on operational success and patient satisfaction.

Key Responsibilities

Appeals Review and Submission

• Investigate rejected or underpaid health insurance claims to determine appeal potential.
• Write customized appeal letters using clinical records, payer guidelines, and claim data.
• Ensure all appeals are submitted on time according to plan-specific rules.
• Work with billing and care teams to complete appeal packets.

Communication and Coordination

• Communicate with insurers and third-party payers to check appeal statuses and resolve delays.
• Update patients and providers about timelines, additional documents, or appeal outcomes.
• Clarify complex insurance explanations to ensure transparency and accuracy.

Documentation and Tracking

• Log appeal actions, outcomes, and follow-ups within the claim management system.
• Maintain HIPAA-compliant notes and secure document trails.
• Track patterns in denials and escalate systemic issues to leadership.

Work Environment

This fully remote position provides flexibility, autonomy, and work-from-home convenience. You’ll be part of a distributed team using cloud-based systems to manage tasks, communicate, and track appeals. The position is ideal for professionals who thrive in structured but independent environments, especially those with experience in digital health administration.

Tools and Technology

• Medical billing software and clearinghouses (e.g., Change Healthcare, Waystar)
• EHR and EMR platforms for accessing patient records
• Secure messaging tools and virtual meeting platforms
• Shared drives and productivity suites like Google Workspace or Microsoft 365
• Insurance portals such as Availity and payer-specific systems

Qualifications and Experience

Required

• At least 3 years of experience handling health insurance appeals, claims corrections, or billing errors
• Familiarity with coding standards (ICD-10, CPT), EOB interpretation, and denial resolution
• Clear, concise written communication and logical appeal writing
• Self-direction, deadline awareness, and strong digital organization

Preferred

• Remote work experience in healthcare or health tech settings
• Background in Medicaid, Medicare, or commercial insurance appeals
• Professional certification (e.g., CPB, CPC, RHIA)

Compensation and Benefits

• Annual salary of $86,480
• Remote-first work model
• Health, dental, and vision benefits
• Paid vacation and company-observed holidays
• Training resources and skill-building support
• 401(k) or equivalent retirement contributions

Growth Opportunities

This role offers a clear path toward leadership in remote claims operations, including advancement to roles such as Appeals Supervisor or Payer Relations Manager. You’ll have access to ongoing learning opportunities and projects focused on optimizing insurance workflows across our digital ecosystem.

How to Succeed in This Role

Success in this position comes from persistence, focus, and the ability to untangle complex insurance issues. You should be confident using digital tools, interpreting payer rules, and communicating with stakeholders to resolve disputes. Candidates with strong decision-making and a passion for equitable healthcare finance will thrive here.

Call to Action

We encourage you to apply if you’re ready to use your appeals expertise to influence healthcare access and reimbursement fairness. Join a mission-driven remote team where your precision and advocacy can help patients get the coverage they deserve.