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Appeals Processor Jobs (NOW HIRING)

CR Fletcher

Appeals Specialist

Syracuse, NY · On-site

Prepare, review, and process appeal documents in accordance with court rules and deadlines. * Monitor appeal timelines and maintain an accurate calendar of filing deadlines. * Coordinate with ...

Independence Blue Cross

Supervisor Appeals

Philadelphia, PA · On-site

$22.25 - $27.50/hr

This role ensures timely, accurate, and compliant processing of member and provider administrative appeals in accordance with NCQA standards, contractual obligations, and organizational policies. The ...

Hall Booth Smith, P.C

Appeals Specialist

Atlanta, GA · On-site

Track and process bill deductions and subsequent appeals across applicable client matters. * Monitor appeal responses and deadlines to help ensure the firm remains in compliance with billing ...

Independence Blue Cross

Supervisor Appeals

Philadelphia, PA · On-site

$22.25 - $27.50/hr

This role ensures timely, accurate, and compliant processing of member and provider administrative appeals in accordance with NCQA standards, contractual obligations, and organizational policies. The ...

OMS MEDICAL BILLING LLC

Appeals Specialist

Addison, TX · On-site

Analyze appeal outcomes and identify trends to improve the appeals process * Stay updated on insurance policies, regulations, and appeal procedures Qualifications * Bachelor's degree in Healthcare ...

MedImpact

Appeals Clinical Specialist

San Diego, CA · On-site

$73.30 - $94.43/hr

Summary The Appeals team oversees all operational and clinical aspects of the appeals process, including intake, case processing, clinical determinations, notifications, and compliance with ...

MedImpact

Appeals Clinical Specialist

San Diego, CA · On-site +1

$73.30 - $94.43/hr

Summary The Appeals team oversees all operational and clinical aspects of the appeals process, including intake, case processing, clinical determinations, notifications, and compliance with ...

Calvert Health System

APPEALS COORDINATOR

Prince Frederick, MD · On-site

$23 - $28.75/hr

... process. The RN Clinical Appeals Nurse will actively manage, maintain and communicate denial/appeal activity to appropriate stakeholders, and report suspected or emerging trends related to payer ...

Calvert Health System

APPEALS COORDINATOR

Prince Frederick, MD · On-site

$23 - $28.75/hr

... process. The RN Clinical Appeals Nurse will actively manage, maintain and communicate denial/appeal activity to appropriate stakeholders, and report suspected or emerging trends related to payer ...

Ogletree Deakins

Billing Appeals Specialist

Albany, NY · On-site

$36.54 - $42.66/hr

Manages the appeals process for insurance carriers' invoices including * Drafting narratives for attorney approval to optimize the rate of appeal successes, * Managing deadlines for all appeals to ...

New

Independence Blue Cross

Clinical Appeals Coord

$22.50 - $28/hr

Position Summary The Clinical Appeals Coordinator, RN is responsible for supporting the end-to-end processing of clinical appeals, including medical necessity, benefit, pharmacy, behavioral health ...

New

Ogletree Deakins

Billing Appeals Specialist

Raleigh, NC

$36.54 - $42.66/hr

Manages the appeals process for insurance carriers' invoices including * Drafting narratives for attorney approval to optimize the rate of appeal successes, * Managing deadlines for all appeals to ...

New

tnhealth

Grievances and Appeals Coordinator

Franklin, TN

$21.75 - $27/hr

The Grievances and Appeals Coordinator processes, tracks and follows up on all medical necessity and administrative denials and appeals for Medicare Advantage members in accordance with Medicare ...

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How much do appeals processor jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for appeals processor in the United States is $17.99, according to ZipRecruiter salary data. Most workers in this role earn between $15.38 and $19.71 per hour, depending on experience, location, and employer.

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

To thrive as an Appeals Processor, you need strong analytical abilities, attention to detail, and familiarity with insurance or healthcare claims processes, often supported by relevant experience or a background in healthcare administration. Proficiency with claims management software, electronic health record (EHR) systems, and knowledge of regulatory guidelines such as HIPAA are typically required. Excellent communication, problem-solving skills, and the ability to manage time effectively help you interact with claimants and work efficiently under deadlines. These skills ensure accurate, timely processing of appeals and compliance with industry standards, directly impacting customer satisfaction and organizational success.

What is the difference between Appeals Processor vs Claims Adjuster?

AspectAppeals ProcessorClaims Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may require insurance licensesHigh school diploma or equivalent; insurance licenses often preferred
Work EnvironmentOffice setting, handling appeals cases and documentationOffice or field setting, investigating and evaluating insurance claims
Industry UsageUsed mainly in insurance companies, government agenciesCommon in insurance companies, healthcare, and auto industries
Search & Comparison IntentPeople comparing roles related to insurance appeals and processingPeople comparing roles involving claim evaluation and adjustment

Appeals Processors focus on reviewing and processing appeals related to denied claims, ensuring compliance and accuracy. Claims Adjusters evaluate insurance claims, investigate damages, and determine payouts. While both roles work within the insurance industry and require similar credentials, Appeals Processors handle appeals cases specifically, whereas Claims Adjusters handle the initial claim assessment and settlement process.

What does an appeals processor do?

An Appeals Processor is responsible for reviewing, analyzing, and making determinations on appeals submitted by clients or claimants, often in the context of insurance, healthcare, or government benefits. They examine supporting documentation, apply relevant policies and regulations, and communicate decisions to all parties involved. Appeals Processors ensure that all appeals are handled fairly, accurately, and within specified timeframes, often acting as a liaison between claimants and organizations.

What are some common challenges faced by appeals processors, and how can they be effectively managed?

Appeals Processors often encounter challenges such as handling high volumes of complex cases, interpreting regulatory guidelines, and meeting strict deadlines. To manage these effectively, it's important to develop strong organizational skills, stay updated on policy changes, and maintain clear communication with other departments like claims and customer service. Many successful Appeals Processors also rely on checklists and workflow tools to ensure accuracy and efficiency, especially when reviewing sensitive or time-critical appeals.

Is claims processing a stressful job?

Claims processing as an appeals processor can be stressful due to tight deadlines, high workload, and the need for accuracy in evaluating complex cases. The role often requires strong attention to detail, communication skills, and the ability to handle sensitive information under pressure.
More about Appeals Processor jobs
What job categories do people searching Appeals Processor jobs look for? The top searched job categories for Appeals Processor jobs are:
Appeals Processor jobs near you
Infographic showing various Appeals Processor job openings in the United States as of August 2026, with employment types broken down into 90% Full Time, 8% Part Time, and 2% Contract. Highlights an 81% Physical, 6% Hybrid, and 13% Remote job distribution, with an average salary of $37,422 per year, or $18 per hour.

Appeals Processor- Anchorage, AK (Hybrid)

Gainwell Technologies

Anchorage, AK • On-site

$37K - $53K/yr

Other

Medical, Retirement, PTO

Posted 15 days ago

Gainwell Technologies rating

7.8

Company rating: 7.8 out of 10

Based on 78 frontline employees who took The Breakroom Quiz

135th of 242 rated software companies

Job description

Appeals Processor- Anchorage, AK (Hybrid)

Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. As Appeals Processor- Anchorage, AK (Hybrid), you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community's most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare's biggest challenges.

Your role in our mission:

  • Review provider appeals using approved guidelines and documents appeal determinations clearly and concisely.
  • Analyze, research and review appeal documentation to ensure all aspects of the appeal have been addressed properly and accurately while maintaining production goals and quality standards.
  • Resubmit and adjust claims on approved appeals with the proper claim data correction and documentation.
  • Maintain performance within defined quality and quantitative objectives.
  • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).

What we're looking for:

  • Total of (2) years or more in medical claims and appeals experience required.
  • Experience working with medical insurance and/or medical terminology preferred.
  • Highly proficient with exceptional level of accuracy required.
  • Ability to research and verify claim payment issues.
  • Knowledge of Microsoft products (Outlook, Word, Excel and TEAMS).

Hybrid role based in Anchorage, Alaska, with an onsite presence required Monday through Friday. Standard working hours are 8:00 AM to 5:00 PM AKST. The deadline to submit applications for this posting is August 10, 2026.

The pay range for this position is $37,500.00 - $53,500.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.

What Gainwell Technologies employees say

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About Gainwell Technologies

Sourced by ZipRecruiter

With Health and Cost outcomes that pierce Inequities and Impact Economies, the success of our Nation’s Federal Medicaid program is inextricably tied to the Prosperity of Communities, States and the Nation as a whole. We think that deserves Respect and a Commitment from Innovators who can help those who operate within and around health and human services evolve to meet their goals. At Gainwell, that’s our Sole focus. Built across more than Five Decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet Agencies, Health plans and MCOs where they are on their modernization journeys and propel them into the future of Healthcare. Equally important to our Expanding Technologies and Results. We bring ideas that bring policies to life.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Irving, TX, US

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