Healthcare Appeals Specialist (Remote) in Portland, Oregon - #72286 | VanderHouwen

Description

Job Id: 72286

Healthcare Appeals Specialist (Remote)
Our client is seeking a detail-oriented and analytical Healthcare Appeals Specialist who excels at navigating complex claims and delivering accurate, timely resolutions. This individual brings strong communication skills, a customer-focused mindset, and the ability to collaborate across clinical and operational teams. The ideal candidate is adaptable, organized, and confident translating complex medical and reimbursement information into clear, actionable outcomes.

This role is fully remote. Applicants must be located in Oregon, Washington, Utah, or Idaho.

Healthcare Appeals Specialist (Remote) Responsibilities

• Analyze, investigate, and resolve provider billing disputes and appeals from intake through final determination and closure.
• Review claims, coding, contracts, policies, and regulatory guidelines to develop well-supported appeal recommendations.
• Coordinate with clinical reviewers, coding specialists, and cross-functional teams to ensure accurate and timely decisions.
• Communicate appeal outcomes and provide guidance to members, providers, and external stakeholders.
• Maintain accurate documentation, track appeal activity, and support reporting, compliance, and process improvement efforts.

Healthcare Appeals Specialist (Remote) Qualifications

• Minimum 4+ years of experience in healthcare claims, customer service, or clinical services, or equivalent combination of education and experience.
• Strong knowledge of medical terminology and coding, including CPT, DX, and HCPCS, with coding certification preferred.
• Proven analytical skills with the ability to research complex issues and make sound, non-clinical determinations.
• Excellent verbal and written communication skills with the ability to explain complex information clearly and professionally.
• Proficiency with Microsoft Office tools and healthcare systems, with the ability to manage multiple priorities in a fast-paced environment.

Compensation: $30-$33/hr. (DOE)

VanderHouwen Contractors Enjoy Exceptional Benefit Perks!
As an eligible contract employee with VanderHouwen, 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.

Meet VanderHouwen
What kind of recruiter do you see yourself working with? One who prioritizes your best interest, no matter what? VanderHouwen does, and we’re in it for the long game! Our recruiters focus on YOU, building meaningful, long-term relationships while developing a deep understanding of companies’ staffing needs and workplace cultures. This approach helps us find an ideal job match that aligns with your unique career aspirations and goals.

VanderHouwen is an award-winning, Women & Diversity-Owned, WBENC certified professional staffing firm. Founded in 1987, VanderHouwen places experienced professionals across the nation! Our recruitment teams specialize in either Technology and IT, Engineering, Human Resources, or Accounting and Finance career markets. Partner with us to land your next exciting career!

VanderHouwen is an Equal Opportunity Employer and participates in E-Verify. VanderHouwen 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.

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