Denial & Appeals Coordinator (REMOTE)

Community Health Systems Professional Services Corporation•Franklin, TN

1d•Remote

About The Position

The Denials & Appeals Coordinator manages, tracks, and resolves denials and appeals to support timely reimbursement. The role requires knowledge of payer guidelines, systems, and requirements to handle complex denial cases, assist with issue resolution, and identify trends that may improve claim outcomes. The position is part of the Payment Compliance and Contract Management (PCCM) team, which oversees the contract lifecycle, analyzes reimbursement discrepancies, improves revenue cycle processes, and supports compliance with contract terms and regulatory requirements. Community Health Systems operates healthcare delivery systems in 40 markets across 15 states, including 71 acute-care hospitals and more than 1,000 other sites of care.

Requirements

High school diploma or GED.
1–3 years of experience in medical billing, revenue cycle, or claims denials and appeals processing.
Prior experience with revenue cycle processes in a hospital or physician office setting.
Strong knowledge of payer guidelines, medical billing practices, and appeal processes.
Proficiency with relevant software and claim management systems, such as Artiva, HMS, Hyland, and BARRT.
Strong analytical skills for reviewing denial trends and suggesting improvements.
Strong verbal and written communication skills for interacting with payers and internal departments.
Ability to prioritize tasks effectively and manage time in a fast-paced environment.

Nice To Haves

Associate degree or higher in Health Information Management.
Certified Revenue Cycle Specialist (CRCS) certification from AAHAM.

Responsibilities

Monitor assigned queues and duties across systems, including Artiva, HMS, Hyland, and BARRT, and ensure follow-up dates are current.
Analyze denials, determine appropriate actions, complete appeals, or route cases for clinical appeals as needed.
File and monitor appeals to resolve payer denials; accurately document activity and maintain logs, account notes, and system records.
Maintain current knowledge of payer guidelines and requirements related to denials and appeals.
Process BARRT requests, review RAC/Government Audit accounts, and complete necessary rebills and adjustments.
Identify denial trends, suggest improvements to reduce future claim issues, and provide data on denial and appeal trends as needed.
Perform other duties as assigned.
Maintain regular and reliable attendance.
Comply with all policies and standards.