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Medical Appeals Specialist (Fully Remote)

Make a measurable impact by overturning denials, recovering missed revenue, and improving patient account outcomes. As a Medical Appeals Specialist, you’ll combine deep payer policy knowledge with analytical problem‑solving—owning complex research, writing strategic appeals, and driving high‑stakes follow‑ups to resolution.

What you’ll do

1) Research & Claims Audit

You’ll be assigned audits with varying volumes of accounts and will pivot priorities based on monthly team targets.

+ Conduct horizontal audits (underpayments across a single payer) and vertical audits (similar denial reasons across multiple payers).

+ Lead Zero Balance investigations: review EOBs/ERAs, identify denial reasons and contractual adjustments, and determine whether to appeal, rebill, or write off.

+ Apply rigorous root‑cause analysis and strategic appeal tactics to overturn denials and recover revenue.

2) Rebilling & Appeal Execution

+ Draft high‑quality appeal letters, confirm submission pathways, and generate “out‑the‑door” rebills for already-vetted claims.

+ Coordinate with payers and clients to ensure appeals are submitted accurately and promptly.

3) High‑stakes Follow‑up

+ Perform advanced outbound follow‑ups on in‑process appeals—interpreting denial letters, validating payer responses, and deciding the best escalation and next steps.

+ Make decisive phone calls to determine denial causes, the correct appeal destination, and whether escalation is warranted.

How you’ll succeed

+ Own the outcome: Make strategic recommendations on account disposition, surface trends to analysts, and help align team priorities to monthly goals.

+ Quality + customer satisfaction: Balance meticulous audit work with meeting deadlines that serve client commitments.

+ Communicate confidently: Very heavy phone work—comfortable initiating calls to solve problems quickly.

Tools & environments

+ Work within client EHRs/EMRs, primarily Epic, Cerner, and Athena.

Must‑have qualifications

+ HS diploma or GED

+ Minimum of 1+ year of Revenue Cycle Management experience specifically in appeals (denials research, root‑cause analysis, and complex payer follow‑ups over the phone)

+ Direct experience with Zero Balance claims and payer denial codes, plus hands‑on complex appeals workflows

+ EMR/EHR experience (ideally Epic and Athena; Cerner exposure a plus)

Nice‑to‑have

+ Third‑party/BPO/vendor background

+ Experience collaborating with analysts to interpret raw claims data and set audit strategy

Why join

+ Solve challenging problems that directly influence cash acceleration

+ Be part of a team that values quality over quantity while still hitting ambitious monthly goals

+ Grow your payer strategy acumen across multiple clients, EMRs, and payers

#westpriority25

Job Type & Location

This is a Contract to Hire position based out of Denver, CO.

Pay and Benefits

The pay range for this position is $23.00 - $25.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Dec 17, 2025.

h4>About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.