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Appeals Associate Jobs (NOW HIRING)

Covenant Health

INSURANCE APPEALS ASSOC

Knoxville, TN · On-site

Overview Insurance Appeals Associate, Revenue Integrity and Utilization Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's top-performing health ...

Aionios LLC

Appellate Associate

Tallahassee, FL · On-site

$175K - $230K/yr

Appellate Associate Location: Tallahassee, FL Experience: 2-3 years Our client, an Am Law 200 full-service law firm, is seeking an Appellate Associate to join its statewide Appellate Practice Group.

Spectraforce Technologies

Appeals Nurse

Des Moines, IA · On-site

Appeals Nurse Duration: 8 Months - Possible extension/Conversion Location: Remote - Iowa Note ... Associates Preferred: Licensure Required: LPN Preferred: RN Years of experience required: at least ...

Humana

Appeals Rep

Hartford, CT · On-site

$48K - $65K/yr

Associate Degree or higher * 2 or more years of Grievance & Appeals experience * Medical claims processing experience * Previous inbound call center/customer service experience * Experience with CAS ...

Humana

Appeals Rep

Baton Rouge, LA · On-site

$48K - $65K/yr

Associate Degree or higher * 2 or more years of Grievance & Appeals experience * Medical claims processing experience * Previous inbound call center/customer service experience * Experience with CAS ...

Humana

Appeals Rep

Topeka, KS · On-site

$48K - $65K/yr

Associate Degree or higher * 2 or more years of Grievance & Appeals experience * Medical claims processing experience * Previous inbound call center/customer service experience * Experience with CAS ...

MedReview

Appeals Specialist

Manhattan, NY · On-site +1

$50K/yr

Associate degree (healthcare field preferred) or an equivalent combination of education, and relevant work experience * 1 year experience working in healthcare claims, appeals, billing or revenue ...

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$46K

$108.2K

$172.5K

How much do appeals associate jobs pay per year?

As of Aug 11, 2026, the average yearly pay for appeals associate in the United States is $108,160.00, according to ZipRecruiter salary data. Most workers in this role earn between $80,000.00 and $130,000.00 per year, depending on experience, location, and employer.

What are some common challenges appeals associates face when reviewing complex cases, and how can they be addressed?

Appeals Associates often encounter cases with incomplete documentation or ambiguous information, which can make it challenging to reach timely and accurate decisions. To address this, they must communicate effectively with internal teams and external parties to gather missing details and clarify uncertainties. Staying up-to-date with changing regulations and organizational policies is also crucial, as appeals often involve nuanced compliance requirements. Collaboration and continuous learning are key to overcoming these challenges and ensuring fair outcomes.

What does an appeals associate do?

An appeals associate reviews and processes appeals related to denied claims, benefits, or decisions within an organization. They analyze case details, gather supporting documentation, and communicate with clients or stakeholders to resolve disputes efficiently, often using specialized case management systems. Strong attention to detail and knowledge of relevant policies are essential for this role.

What are the key skills and qualifications needed to thrive as an appeals associate?

To thrive as an Appeals Associate, you need strong analytical abilities, attention to detail, and a solid understanding of claims processing or legal documentation, often supported by a degree in a related field. Familiarity with case management systems, claims processing software, and regulatory compliance tools is typically required. Excellent written communication, organization, and problem-solving skills are essential soft skills for effectively managing appeals and collaborating with stakeholders. These competencies ensure accurate resolution of appeals, compliance with regulations, and efficient workflow within the organization.

What is the difference between Appeals Associate vs Claims Processor?

CriteriaAppeals AssociateClaims Processor
Required CredentialsHigh school diploma or equivalent; sometimes an associate degree; knowledge of insurance policiesHigh school diploma or equivalent; familiarity with claims processing systems
Work EnvironmentOffice setting, often in insurance or healthcare companiesOffice or remote, handling claims in insurance or healthcare sectors
Employer & Industry UsageInsurance companies, healthcare providers, government agenciesInsurance companies, healthcare organizations, third-party administrators
Common Search & Comparison IntentUnderstanding roles in appeals and claims processesDifferences in claims handling and processing tasks

Appeals Associates focus on reviewing and resolving denied claims or appeals, requiring knowledge of policies and customer communication. Claims Processors handle the initial processing of claims, verifying information and entering data. Both roles are vital in insurance and healthcare industries but differ in their specific responsibilities and stages of claims management.

What cities are hiring for Appeals Associate jobs? Cities with the most Appeals Associate 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 Associate jobs? States with the most job openings for Appeals Associate jobs include:
Appeals Associate jobs near you

INSURANCE APPEALS ASSOC

Covenant Health

Knoxville, TN • On-site

Full-time

Re-posted 12 days ago

Job description

Overview
Insurance Appeals Associate, Revenue Integrity and Utilization
Full Time, 80 Hours Per Pay Period, Day Shift
Covenant Health Overview:
Covenant Health is the region's top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area's fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area's largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes "Best Employer" seven times.
Position Summary:
This position has the responsibility of building patient accounts in the denials management system and performing timely follow-up with regard to clinical and medical necessity insurance appeals. Analyzes all correspondence regarding insurance denials for the Revenue Integrity Auditor to take appropriate action. Prepares necessary documentation for insurance appeals process, ensuring timely follow through. Processes claim adjustments for leadership approval and posts payments as necessary. Maintains integrity of denials management database for accurate statistical and educational reporting. Provides feedback to Revenue Integrity Auditors and Patient Account Representatives as it relates to department operations.
Responsibilities
  • Analyze denials and coordinates insurance appeals.
  • Recognizes situations which necessitate supervision and guidance, seeks appropriate resources.
  • Ensures team members are compliant with front end and back end appeals hand-offs, maintaining payer correspondence and claims processing.
  • Notifies Appeals Supervisor or Revenue Integrity Manager when trends are identified while processing claim denial correspondence and follow-up of appeals.
  • Documents all activities in denials management and financial systems to ensure timely handoffs.
  • Demonstrates the ability to understand billing regulations and payer requirements.
  • Able to handle varying tasks as well as understanding patient accounting processes relative to the revenue process to ensure appropriate reimbursement is received.
  • Communicates effectively with patients/public, co-workers, physicians, facilities, agencies and/or their offices and other facility personnel using verbal, nonverbal, and written communication skills.
  • Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.

Qualifications
Minimum Education:
None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED.
Minimum Experience:
Two (2) years of experience in hospital billing or insurance pre-certification required; Must be familiar with healthcare billing and insurance regulations such as those required by Medicare, Medicaid or Commercial payers. Computer experience is required.
Licensure Requirements:
None.

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