Insurance Appeals Associate, Revenue Integrity and Utilization

Full-time position working 80 hours per pay period on day shift.

Covenant Health is a large community-owned integrated healthcare delivery system headquartered in Knoxville, Tennessee, with hospitals, outpatient services, and physician practices serving more than two million patients and families each year.

This role is responsible for building patient accounts in the denials management system and completing timely follow-up on clinical and medical necessity insurance appeals. The position reviews correspondence related to insurance denials, prepares documentation for the appeals process, processes claim adjustments for leadership approval, posts payments as needed, and maintains accurate denials management records for reporting and education. The role also provides feedback to Revenue Integrity Auditors and Patient Account Representatives to support departmental operations.

Key duties include analyzing denials, coordinating insurance appeals, maintaining payer correspondence, documenting activities in financial and denials systems, understanding billing regulations and payer requirements, and supporting appropriate reimbursement through effective patient accounting processes.

Requirements

High school diploma or GED, or equivalent combination of education and experience

2 years of experience in hospital billing or insurance pre-certification

Familiarity with healthcare billing and insurance regulations, including Medicare, Medicaid, and commercial payer requirements

Computer experience required

Ability to recognize when supervision or guidance is needed and seek appropriate resources

Strong communication skills with patients, coworkers, physicians, facilities, and agencies

Ability to follow policies, procedures, safety standards, and quality improvement initiatives