Appeals Analyst

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

• High school diploma required; Associate's degree or higher preferred
• 2-4 years of experience in appeal and claim processing
• Verbal and written communication
• Customer service
• Analytical skills
• MS Office Suite
• Negotiation, problem recognition, and resolution skills
• Ability to multi-task

Supervisory Responsibilities

Working Environment and Travel Requirements

• Work is typically in a normal office administrative environment involving minimal exposure to physical risks.
• Position requires little to moderate physical activity. Mostly sedentary work exerting up to 10 pounds of force occasionally or a negligible amount of force to lift, carry, push, pull, or otherwise move objects. Work involves sitting most of the time, but may involve walking or standing for brief periods of time. No significant stooping is usually required.
• This role requires travel to our home offices in TN for training.

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:

• Medical/Dental/Vision insurance

• 401K company match

• Flexible Paid Time Off

• Paid parental leave

• HSA/FSA options

• Educational reimbursement program

• Employer-paid EAP & Mental Health services

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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  For information regarding how we collect, use, and protect applicant personal information, please review our CCPA Privacy Notice for Job Applicants.

Originally posted on Himalayas