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The Appeals Analyst investigates denied healthcare claims by reviewing clinical policies, contracts, and supporting documentation to facilitate reimbursement. They also build relationships with payers and providers while documenting all actions taken within the claims recovery system.
Redefining Healthcare with AI
Xsolis is an AI-driven technology company reducing administrative waste in healthcare by enabling smarter collaboration between providers and payers. Since 2013, our vision has been to create a frictionless healthcare system.
We are proudly headquartered in Franklin, TN - one of the nation's fastest-growing hubs for healthcare innovation - we are at the heart of a thriving ecosystem of health systems, payers, and technology leaders.
Our flagship product, Dragonfly®, is the first and only AI-driven platform to continuously assign real-time predictive scores for medical necessity. Dragonfly has delivered proven results across 600+ hospital, health system, and health plan clients and earned repeated industry recognition. With recognition on the Inc. 5000 and Deloitte Technology Fast 500 lists, Xsolis is also one of the fastest-growing privately-held companies in the country and across North America, and we're looking for talented people to grow with us.
Ability to resolve claims by reviewing supporting documentation; calculating benefits due; initiating payment or composing appeal letters; guiding resolution of non-routine claims; auditing claims to ensure appropriate payment.
Ability to maneuver through multiple facility patient accounting systems
Prepares reports by securing analytical information through to a finished product
Analyze claims to determine validity of denial/recovery options
Draft detailed & convincing correspondence to effect reimbursement
Develop relationships with insurance carriers, patients, attorneys, and employers to facilitate reimbursement
Conduct research when necessary to build a strong reimbursement argument
Research/Review clinical policies, contracts, and other media to aide in claims recovery.
Work individually and within a team to identify trends from client inventories and formulate recovery resolution
Clearly and concisely document all actions taken to resolution within a claims recovery system
Ensures legal compliance by following guidelines, contracts, regulations, and the company's business plan
Maintains quality service by following corporate provider and payer service practices and protocols
In any role at Xsolis, it's a chance to make a complex healthcare system a little more efficient alongside a team that's passionate, fast-moving, and genuinely invested in your success. Your contributions will shape both our product and our culture.
Full-time Employees’ Total Rewards package include:
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Xsolis is proud to be an equal opportunity employer. We celebrate diversity and are committed to building an inclusive environment for all. We encourage candidates of every background to apply.
All candidates must successfully pass a background check and fall under the same security role, which includes access to sensitive information, including proprietary data and PHI.
Work Authorization Notice: Please note that we do not provide visa sponsorship or immigration support for this position. Applicants must already be authorized to work in the United States on a full-time, permanent basis without the need for current or future sponsorship.
All official communications from our recruitment team will only come from @xsolis.com. Verify open roles at https://www.xsolis.com/about/careers. For information regarding how we collect, use, and protect applicant personal information, please review our CCPA Privacy Notice for Job Applicants.
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