A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.
Full-time | Onsite TempExperts is seeking a Healthcare Appeals Specialist to support a growing healthcare technology organization in Clearwater, FL . This role plays an important part in ensuring accurate and timely resolution of insurance claim denials while helping improve financial outcomes and support patient access to critical medical services. The ideal candidate will have experience with medical billing, insurance claims, appeals, or revenue cycle management and be comfortable researching claim issues, communicating with insurance providers, and managing multiple cases in a fast-paced healthcare environment. Responsibilities Review and analyze denied insurance claims to determine appropriate appeal strategies. Research claim details, insurance responses, and denial reasons to identify opportunities for resolution. Prepare and submit insurance appeals while ensuring required documentation, payer guidelines, and submission timelines are followed. Communicate with insurance carriers to obtain additional information and resolve outstanding claim issues. Collaborate with billing, coding, and clinical teams to gather supporting documentation needed for appeals. Monitor appeal status, follow up on unresolved cases, and track outcomes. Maintain accurate and organized records of claims, appeals activity, and correspondence within company systems. Perform additional related duties as assigned. Requirements Previous experience in medical billing, claims processing, insurance follow-up, or revenue cycle management required. Experience handling denied claims and insurance appeals strongly preferred. Knowledge of insurance guidelines, Explanation of Benefits (EOBs), payer requirements, and appeal processes. Healthcare or medical device industry experience preferred. Excellent written and verbal communication skills. Strong attention to detail with the ability to research, analyze, and resolve complex issues. Ability to work independently while managing multiple priorities in a fast-paced environment. Strong organizational skills with the ability to meet deadlines and maintain accurate documentation. TempExperts is an Equal Opportunity Employer.
