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Appeals Jobs (NOW HIRING)

Independence Blue Cross

Supervisor Appeals

Philadelphia, PA · On-site

$22.25 - $27.50/hr

Position Summary The Appeals Supervisor oversees day-to-day operations of the administrative (non-clinical)appeals. This role ensures timely, accurate, and compliant processing of member and provider ...

Integrated Resources INC

Appeals Coordinator

Orange, CA · On-site

$23.50 - $29/hr

Appeals Coordinator Duration: 6 + months contract to hire position. Location: San Diego CA 92108 Requirements/Certifications: HS/GED. 1-2 years of appeals/claims/scheduling or coordination experience ...

Integrated Resources INC

Appeals Clerk

Milwaukee, WI · On-site

Appeals Clerk Duration: 3+ months contract Location: Milwaukee, Wisconsin 53224 Shift: 8:00AM to 5:00PM Need strong data entry abilities, healthcare experience and attention to details Will take ...

MC-Rx

Appeals Coordinator

Gainesville, GA

$20.50 - $25.25/hr

Create patient specific appeal letters by incorporating the reason of medical necessity for why the denial should be overturned. * Coordinate prescriber review and signature of completed letters.

Quadax, Inc.

Appeals Specialist

Cleveland, OH

Review assigned denials and EOB's for appeal filing information. Gather any missing information. * Review case history, payer history, and state requirements to determine appeal strategy. * Obtain ...

Massachusetts Trial Court

Appeals Administrator I

Boston, MA · On-site

$63.28K - $84.78K/yr

Appeals Administrator I Pay Grade: Grade 13 Starting Pay: $63,276.46 Salary Range: $63,276.46 (Step 1) - $84,781.32 (Step 8), O.P.E.I.U., Local 6 Salary Schedule Departmental Mission Statement: The ...

Freeman Mathis and Gary LLP

Appeals Coordinator

Atlanta, GA · On-site

$28.84 - $30.29/hr

The Appeals Coordinator is responsible for managing carrier denials and working with attorneys to resolve them. This individual will monitor and analyze insurance notifications, applying them to a ...

Quadax

Appeals Specialist

Middleburg Heights, OH · On-site

Review assigned denials and EOB's for appeal filing information. Gather any missing information. * Review case history, payer history, and state requirements to determine appeal strategy. * Obtain ...

Freeman Mathis & Gary

Appeals Coordinator

Atlanta, GA

$59.99K - $63K/yr

The Appeals Coordinator is responsible for managing carrier denials and working with attorneys to resolve them. This individual will monitor and analyze insurance notifications, applying them to a ...

Globusmedical

Appeals Specialist

Collegeville, PA

The Patient Access Appeals Specialist will work in collaboration with HFX Access, Market Access and Field personnel to provide customer support from prior authorization submission through final ...

Globus Medical

Appeals Specialist

Collegeville, PA · On-site

The Patient Access Appeals Specialist will work in collaboration with HFX Access, Market Access and Field personnel to provide customer support from prior authorization submission through final ...

Quadax, Inc.

Senior Appeals Specialist

Milan, OH

Work as needed in all appeal worklists, potentially with a focus on contracted or sensitive insurance companies. * Communicate denial and appeal trends to client engagement and payer relations teams.

MC-Rx

Appeals Coordinator

Gainesville, GA · On-site

$20.50 - $25.25/hr

Create patient specific appeal letters by incorporating the reason of medical necessity for why the denial should be overturned. * Coordinate prescriber review and signature of completed letters.

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How much do appeals jobs pay per year?

As of May 31, 2026, the average yearly pay for appeals in the United States is $86,480.00, according to ZipRecruiter salary data. Most workers in this role earn between $66,500.00 and $98,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as an Appeals Specialist, and why are they important?

To thrive as an Appeals Specialist, you need a solid understanding of insurance claims processes, healthcare regulations, and strong analytical skills, usually supported by a relevant degree or experience in medical billing or coding. Familiarity with claims management software, electronic health record (EHR) systems, and knowledge of payer-specific guidelines are essential. Attention to detail, persistence, and effective written and verbal communication skills help resolve complex cases and advocate for patients or organizations. These skills ensure timely and accurate resolution of denied claims, maximizing reimbursements and maintaining compliance with industry standards.

What are the main challenges faced by professionals working in appeals, and how can they best navigate them?

Appeals professionals often encounter complex regulations, tight deadlines, and emotionally charged interactions with clients or stakeholders. Navigating these challenges requires strong organizational skills, attention to detail, and the ability to interpret legal or policy documents accurately. Effective communication and collaboration with legal teams, case managers, or external agencies are also essential for building persuasive cases. Staying updated on relevant laws and procedural changes can help appeals specialists advocate successfully and reduce the risk of errors.

What are 'Appeals' jobs?

Appeals jobs involve handling requests to review and potentially overturn previous decisions, often in legal, insurance, healthcare, or government settings. Professionals in this field review cases, gather and analyze evidence, and ensure that appeals processes follow established policies and regulations. They may interact with clients, legal representatives, or regulatory bodies to resolve disputes or clarify decisions. Appeals specialists play a crucial role in ensuring fairness and compliance within their organizations.

What is the difference between Appeals vs Dispute Resolution Specialist?

AspectAppealsDispute Resolution Specialist
CredentialsTypically requires knowledge of appeals processes, legal or administrative certificationsRequires certifications in conflict resolution, negotiation, or mediation
Work EnvironmentOften in government agencies, healthcare, or insurance sectorsCommonly in legal firms, corporate settings, or mediation centers
Employer & IndustryPublic sector, healthcare, insuranceLegal, corporate, consulting
Search & Comparison IntentUnderstanding appeals procedures, filing appealsResolving disputes, mediating conflicts

While both roles involve conflict resolution, Appeals specialists focus on managing formal appeal processes within organizations or agencies, whereas Dispute Resolution Specialists handle broader conflict mediation and negotiation. The roles overlap in conflict management but differ in scope and setting.

More about Appeals jobs
What cities are hiring for Appeals jobs? Cities with the most Appeals job openings:
What are the most commonly searched types of Appeals jobs? The most popular types of Appeals jobs are:
What states have the most Appeals jobs? States with the most job openings for Appeals jobs include:
Appeals jobs near you

Appeals Representative I

Federal Hearings And Appeals

Wilkes Barre, PA • On-site

$40K - $45K/yr

Full-time

Posted 12 days ago

Job description


Applicant must be available for training for 4-6 weeks of training after hire.


About the Role:

The Appeals Representative I plays a critical role in the healthcare and social assistance industry by managing and resolving appeals related to healthcare claims and services. This position is responsible for thoroughly reviewing appeal requests, gathering necessary documentation, and communicating effectively with patients, providers, and internal teams to ensure fair and timely resolution. The role requires a strong understanding of healthcare policies, insurance regulations, and patient rights to accurately assess each case. The Appeals Representative I contributes to maintaining compliance with regulatory standards while striving to deliver exceptional customer service. Ultimately, this position supports the organization's mission to provide equitable healthcare access and resolve disputes efficiently.

Minimum Qualifications:

  • High school diploma or equivalent required; Associate’s degree or higher preferred.
  • Basic knowledge of healthcare terminology, insurance processes, and regulatory requirements.
  • Strong written and verbal communication skills.
  • Proficiency with computer systems and case management software.
  • Ability to handle sensitive information with confidentiality and professionalism.

Preferred Qualifications:

  • Experience working in healthcare claims, appeals, or customer service roles.
  • Familiarity with HIPAA regulations and healthcare compliance standards.
  • Training or certification in medical billing, coding, or healthcare administration.
  • Demonstrated problem-solving skills and ability to manage multiple cases simultaneously.
  • Experience working with diverse populations and maintaining cultural sensitivity.

Responsibilities:

  • Review and analyze appeal requests submitted by patients, providers, or other stakeholders to determine eligibility and validity.
  • Gather and evaluate relevant medical records, billing information, and policy documents to support the appeals process.
  • Communicate clearly and professionally with appellants, healthcare providers, and internal departments to clarify information and provide updates on appeal status.
  • Document all appeal activities accurately in the case management system to ensure transparency and compliance.
  • Collaborate with clinical and legal teams as needed to facilitate complex case reviews and ensure adherence to healthcare regulations.
  • Maintain up-to-date knowledge of healthcare laws, insurance policies, and organizational procedures related to appeals.
  • Meet established performance metrics related to appeal resolution timelines and quality standards.

Skills:

The Appeals Representative I utilizes strong analytical skills daily to review and interpret complex healthcare documentation and insurance policies. Effective communication skills are essential for interacting with patients, providers, and internal teams to clarify appeal details and provide status updates. Attention to detail ensures accurate documentation and compliance with regulatory standards throughout the appeals process. Time management and organizational skills are critical for handling multiple appeals efficiently while meeting deadlines. Additionally, proficiency with case management software and healthcare information systems supports the accurate tracking and resolution of appeals.


on site Monday-Friday
Hours 8am-5pm