Position
Denial & Appeals Specialist
Denials worked, appeals won, revenue recovered.
A denial and appeals specialist owns the denial worklist - reading EOBs, identifying the root cause, drafting appeals with clinical justification, and tracking each appeal to a decision. They turn denied claims back into paid claims and feed root-cause findings into front-end fixes.
What is a denial & appeals specialist?
A denial and appeals specialist owns the denial worklist - reading EOBs, identifying the root cause, drafting appeals with clinical justification, and tracking each appeal to a decision. They turn denied claims back into paid claims and feed root-cause findings into front-end fixes.
What a denial & appeals specialist does day-to-day
Our denial specialists run the daily denial worklist, classify denials by CARC/RARC code, prioritize by dollar value, and route the corrective action - corrected claim, redetermination, peer-to-peer, or formal appeal. They track appeal outcomes and report trends so front-end errors get fixed at the source rather than re-worked downstream.
Daily responsibilities of a denial & appeals specialist
- Daily denial worklist triage by CARC/RARC and dollar value
- Appeal letter drafting with clinical documentation
- Peer-to-peer scheduling and coordination
- Redetermination and reconsideration submission
- Root-cause analysis and front-end feedback
- Weekly denial-and-appeal KPI reporting
Tools & EHRs supported
Practices that hire denial & appeals specialists through Staffing For Doctors
Each practice gets a denial & appeals specialist trained on the EHR, payers, and workflows specific to that specialty.
Cardiology
Prior Authorization Specialist
View specialty roleFamily Medicine
Prior Authorization Specialist
View specialty roleInternal Medicine
Prior Authorization Specialist
View specialty roleOB/GYN
Prior Authorization Specialist
View specialty rolePediatrics
Prior Authorization Specialist
View specialty roleFrequently asked questions
About hiring a denial & appeals specialist from Staffing For Doctors.
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