Job Title: Appeals Specialist
Job Overview:
Contemporary Staffing Solutions is seeking a Appeals Specialist to join our client in a role that supports key business operations and contributes to important organizational initiatives. This Hybrid opportunity is based in Philadelphia, PA and offers a Contract to Hire employment arrangement. The role focuses on reviewing, researching, and resolving complex healthcare related appeals while ensuring compliance with regulatory standards and organizational guidelines. Candidates who thrive in detail oriented environments, enjoy investigative work, and collaborate effectively with cross functional teams will find this position both impactful and rewarding.
Compensation:
$29/hour
Work Schedule:
Monday through Friday, normal business hours, 37.5 hour work week
Key Responsibilities of the Appeals Specialist:

• Manage appeal cases from initial intake through final resolution, ensuring accuracy, completeness, and adherence to required timelines.
• Analyze benefit information, claims data, authorization records, supporting documentation, and applicable regulations to determine appropriate case outcomes.
• Prepare detailed documentation, correspondence, and case summaries that clearly support findings, decisions, and required follow up actions.
• Coordinate with members, healthcare providers, authorized representatives, and internal stakeholders to gather information, address inquiries, and facilitate case progression.
• Monitor outstanding activities, resolution efforts, and case inventories while identifying risks, escalating concerns, and ensuring timely completion of required actions.

Qualifications and Skills for the Appeals Specialist:

• Bachelor’s degree in Healthcare Administration, Business, Population Health, or a related field.
• At least 3 years of experience within healthcare operations, with previous exposure to appeals, grievances, utilization review, or similar functions preferred.
• Knowledge of healthcare benefit plans, claim processing practices, and related operational procedures.
• Strong research, analytical, problem solving, and organizational abilities with the capacity to manage complex case matters independently.
• Excellent written and verbal communication skills, including experience preparing professional documentation, reviewing content for accuracy, and providing outstanding customer service.

Why Join Us?
This opportunity offers hands on experience within a highly regulated healthcare environment where your work directly supports operational quality and effective case resolution. You will collaborate with a variety of professionals, gain exposure to important business processes, and further develop your analytical, communication, and compliance related skills. The role provides meaningful involvement in day to day operations with the potential for long term career growth.
About Us:
Contemporary Staffing Solutions (CSS) is a trusted leader in providing contract, temporary, temp to hire, and direct hire staffing solutions. With decades of experience, we have grown from a staffing agency into a nationwide provider of workforce management solutions. Our niche recruitment expertise spans Accounting & Finance, Call Center & Office Support, Human Resources, Sales & Marketing, and Information Technology. Explore more about CSS and how we connect great talent with exceptional opportunities by visiting Contemporary Staffing Solutions.