Billing Appeals Specialist

Billing Appeals Specialist This role is ideal for a detail‑oriented, analytically minded professional who thrives in complex, regulated environments and approaches sensitive situations with professionalism and empathy. The successful candidate brings a strong balance of critical thinking, clear communication, and operational discipline, along with the ability to manage competing priorities while delivering accurate, timely outcomes. A collaborative mindset and comfort navigating nuanced reimbursement and policy scenarios are key to success in this role.

This role is fully remote with PST hours required. Applicants located in Oregon, Washington, Utah, or Idaho are preferred.

• Manage end‑to‑end billing appeal cases, including intake, analysis, coordination, determination, and closure within established guidelines and timelines.
• Analyze claims, coding, contracts, policies, and regulatory requirements to develop well‑supported, non‑clinical appeal recommendations.
• Collaborate closely with internal clinical reviewers, coding specialists, and cross‑functional partners to resolve complex appeal matters.
• Communicate appeal decisions clearly and professionally to internal and external stakeholders, ensuring transparency and compliance.
• Maintain accurate documentation, track appeal activity, and contribute to reporting, quality improvement, and process adherence.

• Demonstrated experience handling complex billing, claims, or appeals work in a healthcare or insurance environment.
• Strong working knowledge of medical terminology, coding standards, and claims or reimbursement processes.
• Excellent written and verbal communication skills, with the ability to explain complex information diplomatically and clearly.
• Proven ability to prioritize a caseload, adapt quickly to shifting demands, and meet strict quality and timeliness standards.
• High level of professionalism, discretion, and attention to confidentiality in all interactions and documentation.

As an eligible contract employee with Vander Houwen, you’ll have access to a full suite of benefits designed with your well‑being in mind. Our comprehensive package includes medical, dental, vision, life insurance, short‑ and long‑term disability, and a matching 401(k) to help secure your future.

Vander Houwen is an Equal Opportunity Employer and participates in E‑Verify. Vander Houwen does not discriminate based on race, color, religion, sex, national origin, age, disability, or any other characteristic protected by applicable local, state, or federal civil rights laws.