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Appeals Representative Jobs (NOW HIRING)

RemX

Appeals Representative

Beverly Hills, CA · On-site

$17 - $18/hr

Medical Billing Appeals Representative 📍 Office-Based Role | Full-Time Are you detail-driven with a passion for solving complex billing issues? Join our team as a Medical Billing Appeals ...

TeamHealth

Appeals Representative

Louisville, TN · On-site

... appeal disputed claims • Assembles and forwards appropriate documentation to the senior representative for provider and carrier related issues • Reviews carrier provider manuals for billing ...

CERiS

Appeals Representative II

$18.80 - $30.34/hr

The Appeals Representative is responsible for addressing provider inquiries and appeals via email, fax, telephone, or written correspondence ensuring adherence to client policy, industry standards ...

TeamHealth

Appeals Representative

Louisville, TN · On-site

Identifies and forwards documentation to appeal disputed claims * Assembles and forwards appropriate documentation to the senior representative for provider and carrier related issues * Reviews ...

Corvel

Appeals Representative II

$18.80 - $30.34/hr

The Appeals Representative is responsible for addressing provider inquiries and appeals via email, fax, telephone, or written correspondence ensuring adherence to client policy, industry standards ...

Corvel

Appeals Representative II

Fort Worth, TX · Remote

$20.08 - $30.06/hr

The Appeals Representative is responsible for reviewing, analyzing, and addressing provider inquiries and appeals via email, fax, telephone, or written correspondence in accordance with regulatory ...

Corvel

Appeals Representative II

Fort Worth, TX · On-site +1

$18.80 - $30.34/hr

The Appeals Representative is responsible for addressing provider inquiries and appeals via email, fax, telephone, or written correspondence ensuring adherence to client policy, industry standards ...

CERiS

Appeals Representative II

Fort Worth, TX · Remote

$20.08 - $30.06/hr

The Appeals Representative is responsible for reviewing, analyzing, and addressing provider inquiries and appeals via email, fax, telephone, or written correspondence in accordance with regulatory ...

Corvel

Appeals Representative I

Fort Worth, TX · Remote

$17.47 - $26.08/hr

The Appeals Representative is responsible for reviewing, analyzing, and addressing provider inquiries and appeals via email, fax, telephone, or written correspondence in accordance with regulatory ...

TeamHealth

Appeals Representative

Alcoa, TN · On-site

Knowledge of healthcare reimbursement guidelines, ICD-10 and CPT-4 coding, appeals process and physician billing preferred. * Proficient in Microsoft Office. * Must possess excellent oral and written ...

CERiS

Appeals Representative II

Fort Worth, TX · On-site +1

$18.80 - $30.34/hr

The Appeals Representative is responsible for addressing provider inquiries and appeals via email, fax, telephone, or written correspondence ensuring adherence to client policy, industry standards ...

CERiS

Appeals Representative II

Fort Worth, TX · Remote

$18.80 - $30.34/hr

The Appeals Representative is responsible for addressing provider inquiries and appeals via email, fax, telephone, or written correspondence ensuring adherence to client policy, industry standards ...

Corvel

Appeals Representative I

Fort Worth, TX · On-site

$17.47 - $26.08/hr

The Appeals Representative is responsible for reviewing, analyzing, and addressing provider inquiries and appeals via email, fax, telephone, or written correspondence in accordance with regulatory ...

Corvel

Appeals Representative II

Fort Worth, TX · Remote

$18.80 - $30.34/hr

The Appeals Representative is responsible for addressing provider inquiries and appeals via email, fax, telephone, or written correspondence ensuring adherence to client policy, industry standards ...

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Appeals Representative information

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$12

$24

$50

How much do appeals representative jobs pay per hour?

As of Jun 12, 2026, the average hourly pay for appeals representative in the United States is $24.55, according to ZipRecruiter salary data. Most workers in this role earn between $14.90 and $28.85 per hour, depending on experience, location, and employer.

What Does an Appeals Representative Do?

Appeals representatives review and process medical policies, grievances, and denials of medical claims. As an appeals representative, your duties are to review each complaint and denial, contact customers to gather details of their case, document the process as it moves through the system, provide a report regarding case statistics, and prepare for appeal hearings. You are also responsible for analyzing the policy connected with a claim to determine company liability. All cases need documentation for final case determination.

What jobs pay $2000 a day?

Some high-paying roles for Appeals Representatives or similar positions in specialized fields can reach $2,000 per day, especially with extensive experience, advanced certifications, or in high-stakes environments like insurance appeals or legal consulting. These roles often require strong negotiation skills, knowledge of regulations, and the ability to handle complex cases efficiently.

What job makes $10,000 a month without a degree?

Appeals Representatives typically do not earn $10,000 a month without a degree; most roles in this field have lower salaries and require strong communication and negotiation skills. High-paying jobs that can reach this level often involve sales, entrepreneurship, or specialized trades, but they usually require experience, certifications, or entrepreneurial effort rather than formal degrees.

What skills do you need to be an appeals specialist?

Appeals specialists need strong communication and analytical skills to review cases and explain decisions clearly. Attention to detail, problem-solving abilities, and knowledge of relevant policies or regulations are essential. Proficiency with computer systems and documentation tools is also important for managing case information efficiently.

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

To thrive as an Appeals Representative, you need a solid understanding of insurance policies, claims processing, and healthcare regulations, often supported by a relevant associate or bachelor’s degree. Familiarity with claims management software, medical coding systems like ICD-10, and proficiency in Microsoft Office are typically required. Strong attention to detail, analytical thinking, and effective written and verbal communication skills help distinguish top performers in this role. These competencies ensure accurate resolution of appeals, compliance with regulations, and effective advocacy for clients or patients.

What does an appeals representative do?

An appeals representative reviews and processes appeals related to denied claims, benefits, or decisions. They evaluate documentation, communicate with claimants, and work to resolve disputes accurately and efficiently, often using specialized case management systems.

What is the difference between Appeals Representative vs Claims Processor?

CriteriaAppeals RepresentativeClaims Processor
Required CredentialsHigh school diploma or equivalent; sometimes certifications in insurance or healthcareHigh school diploma or equivalent; often familiarity with insurance policies
Work EnvironmentOffice setting, handling customer or provider appealsOffice setting, reviewing and processing insurance claims
Employer & Industry UsageInsurance companies, healthcare providers, government agenciesInsurance companies, healthcare organizations, third-party administrators
Common Search & Comparison IntentUnderstanding roles related to appeals and dispute resolutionUnderstanding claims processing and related job functions

Appeals Representatives focus on reviewing and resolving disputes related to denied claims, often requiring knowledge of insurance policies and customer service skills. Claims Processors primarily handle the initial review and processing of insurance claims, ensuring accuracy and completeness. While both roles work within the insurance and healthcare industries, Appeals Representatives specialize in appeals and dispute resolution, whereas Claims Processors focus on claim intake and processing.

How does an Appeals Representative typically collaborate with other departments during the appeals process?

As an Appeals Representative, you'll often work closely with teams such as claims processing, medical review, and customer service to gather necessary documentation and clarify case details. Collaboration is essential for ensuring appeals are evaluated accurately and efficiently, as you may need to request additional information, verify policy interpretations, or communicate with healthcare providers. This cross-departmental teamwork helps resolve member concerns and supports compliance with regulatory guidelines, making strong communication and organizational skills especially valuable in this role.
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Appeals Representative jobs near you
Infographic showing various Appeals Representative job openings in the United States as of June 2026, with employment types broken down into 100% Full Time. Highlights an 44% In-person, and 56% Remote job distribution, with an average salary of $51,068 per year, or $24.6 per hour.

Appeals Representative I

Federal Hearings And Appeals

Wilkes Barre, PA • On-site

$40K - $45K/yr

Full-time

Posted 24 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