Appeal Operations Specialist Job at Cash App (Denver)

Vehicle Ad Optimization Specialist

We’re seeking a skilled and detail-oriented mid-level professional to play a key...

Location

Albania , Tirane

Salary:

Not provided

AUTO1 Group

Expiration Date

Until further notice

Requirements

Experience in the automotive industry (e.g., vehicle sales, appraisals, inspections, or similar roles)
Basic technical knowledge of cars, including service histories, equipment, and features
A structured, detail-oriented approach to handling information and processes
Strong communication skills and fluency in English

Job Responsibility

Conducting thorough checks on vehicle service histories to ensure accuracy
Identifying and documenting car equipment and features for advertisements
Supporting the creation of high-quality vehicle listings that appeal to buyers across the EU market
Collaborating with the team to ensure compliance with automotive standards
Staying updated on industry trends to improve processes and ensure accurate representations

What we offer

Competitive salary with fixed and performance-based components
Be part of an innovative, fast-paced team that’s transforming the automotive sector
Opportunities for professional growth in a dynamic and merit-based environment

Fulltime

Appeals Specialist I

Responsible for all activities associated with requests for Provider Billing Dis...

Location

United States , Portland

Salary:

25.00 - 30.00 USD / Hour

Apex Systems

Expiration Date

Until further notice

Requirements

Excellent verbal and written communication skills
Intermediate computer skills (e.g. Microsoft Word, Excel, Outlook)
Knowledge of medical terminology, anatomy and coding (CPT, DX, HCPCs)
Knowledge of claims processing and clinical services operations
Demonstrated initiative and analytical ability in identifying problems, researching issues, developing solutions, and implementing a course of action
Ability to listen and communicate appropriately in a manner that promotes positive, professional interaction while maintaining confidentiality and sensitivity in all aspects of internal and external contacts
Ability to present complex medical and reimbursement information to others and to be diplomatic and persuasive regarding health plan benefits, claims and eligibility
Ability to switch from one task or type of work to another as the business needs require
Ability to effectively prioritize work to meet strict timelines while maintaining quality and consumer centric focus
High school diploma or GED and a minimum 4 years’ experience in customer Service, Claims, or Clinical Services or equivalent combination of education and work experience

Job Responsibility

Responsible for all activities associated with appeal analysis, decision-making and closure
Appeal Intake – Validate intake determinations regarding timeliness, member benefits, employer group, and provider contract provisions for each appeal. Document information in appropriate system
Appeal Analysis – Review claim coding and claim processing history, medical policy and reimbursement policies, regulatory and legal requirements, benefit contracts, and/or provider contracts. Collect and catalogue supporting documentation and formulate an appeal recommendation. Document information in appropriate system. Apply knowledge and experience to answer a variety of increasingly complex inquiries from members, providers, and provider representatives. Collaborate effectively with coding specialists, appeal nurses, physician reviewers, and others as necessary to reach timely decisions on appeals
Decision & Closure – Make non-clinical appeal determinations as permitted by department business processes and guidelines. Follow department’s processes to receive a clinical review and decision from licensed health professionals. Present complex cases to appeal panels, document decisions, communicate determinations to members, providers or their representatives. Document information in appropriate system(s)
External review process – Oversee set-up of appeals for external review organizations, including document collection and coordination, communication with all parties, and other responsibilities as an intermediary between the provider and the external review organization. Ensure external review information is documented in appropriate system. Prepares letters and cases for external review as needed. Implement external review decisions
Interpersonal and Communication – Provide information, education and assistance to members, providers, and their representatives. Facilitate the member’s or provider’s’ understanding of the appeal process and of the information necessary to effectively process an appeal. Be a courteous advocate to the member or provider when requesting supporting information. Work cooperatively and effectively across all business areas to resolve
Systems and data – Track appeals in appropriate systems and assist in the maintenance of files. Assist with compilation of reports on appeals, including trends, number of cases, decisions, suggestions for process improvement, types of appeals, and compliance with timelines
Support, apply and promote Provider or Member Appeal Policies & Procedures
Adhere to dependability, customer focus, and all performance criteria as established by the department including: timeliness, production, and quality standards for all work
Manage a defined caseload within department productivity and quality expectations and provide back up for other appeals staff

What we offer

Medical, dental, vision, life, disability, and other insurance plans
ESPP (employee stock purchase program)
401K program with company match after 12 months
HSA (Health Savings Account on the HDHP plan)
SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions
Corporate discount savings program
On-demand training program
Access to certification prep and a library of technical and leadership courses/books/seminars after 6+ months of tenure
Certification discounts and other perks to associations that include CompTIA and IIBA
Dedicated customer service team for Consultants

Fulltime

Medical Biller/Collections Specialist

We are looking for an experienced Medical Biller/Collections Specialist to join ...

Location

United States , Mt Laurel Township

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Minimum of 2 years of experience in medical billing for Medicare and Medicaid
Proficiency in handling medical collections and accounts receivable
Strong knowledge of medical denials and appeals processes
Expertise in hospital billing operations and documentation
Familiarity with healthcare insurance regulations and compliance standards
Excellent analytical and problem-solving skills
Effective communication abilities for interacting with insurance providers and healthcare teams
Detail-oriented approach to ensure accuracy in billing and record-keeping

Job Responsibility

Accurately process medical billing for Medicare and Medicaid claims, ensuring compliance with regulatory standards
Handle accounts receivable tasks, including tracking and resolving outstanding balances
Investigate and manage medical denials, implementing solutions to ensure proper claim resolution
Prepare and submit medical appeals to recover denied or underpaid claims
Conduct hospital billing operations, maintaining accuracy and consistency in documentation
Communicate with insurance providers to address claim discrepancies and secure timely reimbursements
Maintain detailed records of billing and collection activities for auditing purposes
Collaborate with healthcare providers and administrative teams to streamline billing processes
Identify opportunities to improve efficiency within the billing and collections workflow
Provide regular updates on accounts and collections to management

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

New

Contract Compliance Analyst III

The Contract Compliance Analyst III will facilitate contract implementation and ...

Location

United States , Madison

Salary:

51000.00 - 84000.00 USD / Year

Exact Sciences

Expiration Date

Until further notice

Requirements

3+ years of experience in billing/reimbursement, coverage, claims, and appeals
Demonstrated understanding of public and private Managed Care payers and reimbursement process
Demonstrated understanding of market-related issues, contract basics, product coverage, and pull through rationale
Proficient with Excel and Epic or similar database
demonstrated ability to maintain competency levels
Demonstrated ability to perform the Essential Duties of the position with or without accommodation
Applicants must be currently authorized to work in country where work will be performed on a full or part-time basis. We are unable to sponsor or take over sponsorship of employment visas at this time.

Job Responsibility

Develop communication for contracts, amendments, and notifications for the internal Revenue Cycle Team (RCT) customers and collaborate with the Field Managed Care team in negotiations with payers for operational optimization
Play a role in the development and maintenance of a contract database and contract management system, working with the credentialing and legal teams
Collaborate with finance and analytics to identify, analyze, and determine next steps to address negative revenue pull-through scenarios specific to payers and across payer segments
including Medicare Advantage, Blues, Medicaid, etc.
Collaborate with RCT Managers and specialists to develop and leverage relationships with billing operations staff and payers when resolving claim adjudication issues, both contractual and non-contractual
Support execution of pull-through plans to meet quarterly/annual revenue recovery goals
Identify broad revenue opportunities that span a particular customer segment
including utilizing Content Management Systems (CMS) for noncontracted Managed Medicare non-payments and the Employer Coalition initiative
Consistently identify opportunities to recover revenue
Collaborate with the Managed Care team to identify and prioritize plan(s) utilizing key payers for targeted efforts to impact coverage policy decisions

What we offer

paid time off (including days for vacation, holidays, volunteering, and personal time)
paid leave for parents and caregivers
a retirement savings plan
wellness support
health benefits including medical, prescription drug, dental, and vision coverage
bonus eligible.

Fulltime

New

Medical Billing Specialist

We are looking for an experienced Medical Billing Specialist to join our team in...

Location

United States , Rochester

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Proven experience in medical billing, including claims processing and appeals management
Familiarity with accounting software systems and tools such as Medisoft and Epic
Proficiency in Microsoft Excel for data analysis and reporting
Knowledge of EHR systems, including experience with Epic and IBM AS/400
Strong understanding of accounts receivable and collection processes
Ability to navigate healthcare billing codes and insurance policies effectively
Exceptional attention to detail and organizational skills
Strong communication abilities to collaborate with internal teams and external stakeholders

Job Responsibility

Process and manage medical claims with precision, ensuring compliance with healthcare regulations
Utilize accounting software systems to maintain accurate billing records and financial data
Handle accounts receivable tasks, including tracking payments and resolving discrepancies
Oversee appeals and claims administration to address denied or delayed claims effectively
Perform collection activities to recover outstanding balances while maintaining professionalism
Operate within EHR systems and tools such as Epic and Medisoft to streamline billing functions
Generate detailed financial reports using Microsoft Excel to support organizational decision-making
Collaborate with internal teams to optimize billing workflows and improve efficiency
Maintain up-to-date knowledge of healthcare billing codes and insurance policies
Support the integration and use of IBM AS/400 and other relevant systems for billing processes

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Appeals Administrative Support

You will be working for our client who is a tech lead, award winning company as ...

Location

United Kingdom , South Croydon

Salary:

25400.00 GBP / Year

Office Angels

Expiration Date

Until further notice

Requirements

Ability to work in a fast paced environment and in a team
Ability to learn quickly and work to a high standard at all times
Experience in a administrative role with a passion for beating targets
A good command in English language and the ability to write letters
The ability to work well under pressure and to meet deadlines
The ability to apply discretion and sensitivity in dealing with complicated cases
Professional, hardworking and prepared to go above and beyond
Graduate level or equivalent
Strong IT skills, including Excel and Word

Job Responsibility

Administer the enforcement process end-to-end through specialist software
Working with the wider team to ensure cases are solved with good time management
Operating in a fast-paced, multi-faceted environment addressing a wide range of topics

What we offer

Beautiful Office right by East Croydon Station with a hybrid working environment
The chance to work at one of the UK's top startups and to grow into more senior roles with structured training and management
Weekly team lunches on Monday and regular company socials

Fulltime

Appeals Administrative Support

You will be working for our client who is a tech lead, award winning company as ...

Location

United Kingdom , South Croydon

Salary:

22000.00 - 25000.00 GBP / Year

Office Angels

Expiration Date

Until further notice

Requirements

A good command in English language and the ability to write letters
The ability to work well under pressure and to meet deadlines
The ability to apply discretion and sensitivity in dealing with complicated cases
Professional, hardworking and prepared to go above and beyond
Graduate level or equivalent
Strong IT skills, including Excel and Word

Job Responsibility

Administer the enforcement process end-to-end through specialist software
Working with the wider team to ensure cases are solved with good time management
Operating in a fast-paced, multi-faceted environment addressing a wide range of topics

What we offer

Beautiful Office right by East Croydon Station with a hybrid working environment
The chance to work at one of the UK's top startups and to grow into more senior roles with structured training and management
Weekly team lunches on Monday and regular company socials

Fulltime

Insurance Billing Specialist

As an Insurance Billing Specialist, you’ll help families access the medical equi...

Location

United States

Salary:

65155.00 - 78227.00 USD / Year

Babylist

Expiration Date

Until further notice

Requirements

3+ years of direct experience in DME billing and insurance reimbursement, managing the full claim lifecycle from eligibility verification through appeals and collections
Confidently review EOBs, identify payment discrepancies, denials, and adjustments, and take appropriate follow-up actions with minimal oversight
Worked extensively in Brightree and NikoHealth or comparable billing platforms, and are comfortable navigating EMRs like Epic, Kareo, or AdvancedMD to document and track claim progress
Working understanding of CPT, HCPCS, ICD-10, and relevant DME billing regulations such as HIPAA, CMS, and ERISA, and apply them accurately in your daily work
Spot issues others miss, ensuring claims are submitted cleanly, documentation is complete, and no step in the process is overlooked—even at high volume
Explain complex billing issues clearly and professionally, whether you're resolving a patient inquiry, collaborating with internal teams, or working with payers to resolve a denial
Thrive in a contributor role that values mastery, precision, and process excellence
Open to using AI tools that improve workflow efficiency and accuracy, and willing to adapt as the team adopts new technologies that enhance billing operations

Job Responsibility

Verify insurance: Conduct timely and accurate eligibility checks and benefit investigations through payer portals and phone outreach to ensure claims are submitted correctly from the start
Submit and track: Enter and monitor DME claims across multiple platforms, troubleshoot billing issues, and proactively follow up to reduce denials and accelerate reimbursement
Review and resolve: Analyze explanation of benefits (EOBs) for errors, missing payments, or misapplied patient responsibility, then determine and execute the correct resolution path
Draft and submit: Write detailed, well-supported appeals that address denial reasons clearly and improve chances of successful claim recovery
Investigate and escalate: Work aging reports weekly to identify unpaid or incorrectly paid claims, collaborate with payers or escalate internally as needed to drive resolution
Communicate clearly: Provide clear and empathetic responses to patients with billing questions, helping them understand their benefits and out-of-pocket costs without confusion
Collaborate cross-functionally: Work with Billing teammates, Customer Experience, Fulfillment, and cross-functional partners to identify process gaps and improve billing operations end to end
Leverage AI: Use AI-enabled tools that assist with eligibility, claims validation, and documentation to improve efficiency while maintaining billing accuracy and compliance
Support families: Ensure timely access to medically necessary DME by reducing billing friction, shortening reimbursement cycles, and ensuring every claim is processed with care

What we offer

Competitive salary with equity and bonus opportunities
Company-paid medical, dental, and vision insurance
Retirement savings plan with company matching and flexible spending accounts
Generous paid parental leave and PTO
Remote work stipend to set up your office
Perks for physical, mental, and emotional health, parenting, childcare, and financial planning

Fulltime

Appeal Operations Specialist

Cash App

Location:
United States , Denver

Category:
IT - Administration

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
January 26, 2026

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Job Posted:January 26, 2026

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