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Appeals Specialist II - RN (REMOTE)

May 13, 2026

Benefits<ul style="margin-bottom: 0px; margin-top: 0px; padding-inline-start: 48px;"><li dir="ltr" aria-level="1" style="background-color: transparent; color: rgb(0, 0, 0); font-family: Arial, sans-serif; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; list-style-type: disc; text-decoration: none; vertical-align: baseline; white-space: pre;">Comprehensive Health Coverage – Medical, dental, and vision plans to keep you and your family healthy.</li><li dir="ltr" aria-level="1" style="background-color: transparent; color: rgb(0, 0, 0); font-family: Arial, sans-serif; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; list-style-type: disc; text-decoration: none; vertical-align: baseline; white-space: pre;">Future Security: 401(k) with matching</li><li dir="ltr" aria-level="1" style="background-color: transparent; color: rgb(0, 0, 0); font-family: Arial, sans-serif; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; list-style-type: disc; text-decoration: none; vertical-align: baseline; white-space: pre;">Student Loan Support – Up to $10,000 repayment assistance, because we invest in your future.</li><li dir="ltr" aria-level="1" style="background-color: transparent; color: rgb(0, 0, 0); font-family: Arial, sans-serif; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; list-style-type: disc; text-decoration: none; vertical-align: baseline; white-space: pre;">Educational Tuition Assistance</li><li dir="ltr" aria-level="1" style="background-color: transparent; color: rgb(0, 0, 0); font-family: Arial, sans-serif; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; list-style-type: disc; text-decoration: none; vertical-align: baseline; white-space: pre;">Competitive Pay & Full Benefits – A salary and package designed to reward your expertise and dedication.</li></ul>Job Summary The Appeal Specialist II reviews, analyzes, and resolves insurance denials to ensure accurate reimbursement and regulatory compliance. This role logs and reviews denials for trend reporting, provides feedback to facilities, and communicates payer updates to relevant stakeholders. The Appeal Specialist II collaborates with internal teams to ensure timely and thorough appeal resolution and supports initiatives that improve denial prevention and recovery processes. Essential Functions<ul><li>Reviews and resolves pre-payment insurance denials in collaboration with follow-up teams.</li><li>Coordinates with Denial Coordinators, Facility Denial Liaisons, and Managed Care Coordinators to ensure payer accountability and identify education opportunities.</li><li>Provides feedback to facilities regarding denials resulting in retractions or reimbursement impacts.</li><li>Monitors payer billing and coding updates and communicates changes to SSC and ancillary departments.</li><li>Tracks and logs denials and appeal activity according to established documentation and reporting guidelines.</li><li>Prepares and distributes reports summarizing appeal trends, project updates, and payer response activity.</li><li>Recommends process improvements to enhance appeal efficiency and reduce recurring denials.</li><li>Maintains up-to-date knowledge of payer policies, billing and coding practices, and reimbursement regulations.</li><li>Utilizes practice management systems and maintains documentation of appeal activity in compliance with departmental standards.</li><li>Performs other duties as assigned.</li><li>Maintains regular and reliable attendance.</li><li>Complies with all policies and standards.</li></ul> Qualifications<ul><li>H.S. Diploma or GED required</li><li>Bachelor's Degree in Nursing preferred</li><li>2-4 years of experience in healthcare revenue cycle or business office required</li><li>1-3 years of experience in healthcare insurance or medical billing preferred</li></ul> Knowledge, Skills and Abilities<ul><li>Proficiency in word processing, spreadsheet, and database applications.</li><li>Working knowledge of billing, coding, and reimbursement principles.</li><li>Strong analytical, research, and problem-solving skills.</li><li>Ability to communicate effectively with payers, facility staff, and leadership.</li><li>Strong organizational and documentation skills with attention to detail.</li><li>Ability to work independently and manage multiple priorities in a fast-paced environment.</li><li>Understanding of insurance claims processing and denial management workflows.</li></ul> Licenses and Certifications<ul><li>RN - Registered Nurse - State Licensure and/or Compact State Licensure required</li></ul> Community Health Systems is one of the nation's leading healthcare providers. With healthcare delivery systems in 36 distinct markets across 14 states, CHS operates 69 affiliated hospitals with more than 10,000 beds and approximately 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, imaging centers, cancer centers, and ambulatory surgery centers.

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DISCLAIMER

Get Hired Faster With COMPANY_NAME!

1: COMPANY_NAME Smart Tools and Direct Employer Connections Help Speed Up Your Hiring Process

2: With Better Matches, Real-time Job Alerts, and Direct Employer Responses, COMPANY_NAME Helps Many Candidates Secure Interviews and Job Offers Within 15 to 30 Days!

3: The Type of Resume You Need to Get Priority Placement

4: Browse Full-Time, Part-Time, and Freelancing Roles With COMPANY_NAME

5: COMPANY_NAME Helps You Grow Your Career

6: The Easiest Way To Find A Job

7: Find Roles That Offer Growth, Culture & Benefits

8: Get Support With Resume, Interviews & Career Planning

9: Your Future Starts Today

10: Get Hired Within 15 to 30 Days With COMPANY_NAME

Appeals Specialist II - RN (REMOTE)

Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

5. HOW DO YOU PROCESS INFORMATION?

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

8. HOW TO PRIORITIZE WORK?

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

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