Claims Processor

Talent Navigation Experts is a boutique staffing firm in Denver, delivering all of your recruiting needs. We’re more than just headhunters; we provide best-in-class service for both Denver companies and the top talent they want to recruit. Job searches can be difficult, both for companies and candidates.

At Talent Navigation Experts, we guide Denver companies through the recruiting process with a customized staffing model built just for them. Quite simply, we bring great companies and great candidates together.

About the Role:

We are seeking a Claims & Appeals Specialist with strong experience in facility-level claims, preferably from the payer side. This individual will manage appeals, resolve claims issues (including PENS), and communicate with providers and internal stakeholders. The role involves roughly 2 hours of daily phone work, with the remainder of the day focused on appeals and claims resolution. This is a hybrid role with the potential to become fully remote.

Required Skills:

• Facility claims and appeals processing experience

• Strong knowledge of Medicare and Medicaid claims

• Excellent phone communication skills and comfort working with providers

• Ability to work independently and make appeal decisions

• Experience collaborating with auditors, nurses, and physicians

• Proficiency with Microsoft Teams

Preferred Skills:

• Experience with PCM claims software (highly preferred)

• Familiarity with BRG coding and hospital claim workflows

• Background working with claims that fall out of systems (PENS)

• Previous call center experience (for contract-to-hire track)

About the Company:

Our client is a leading healthcare payer organization committed to improving claims accuracy and supporting providers through transparent, timely resolutions. They offer a supportive environment with flexibility, professional development, and opportunities to work cross-functionally with clinical and compliance teams.

Hourly: $20-$25

Talent Navigation Experts is an Equal Opportunity/Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity employer.