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Appeals Representative Jobs (NOW HIRING)

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 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 ...

CorVel

Appeals Representative II

Fort Worth, TX · On-site

$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 ...

CERiS

Appeals Representative II

Fort Worth, TX · On-site

$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 ...

divvyDOSE

Senior Appeals Representative

Las Vegas, NV · On-site

$20.38 - $36.44/hr

Senior Appeals Representative At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the ...

New

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 ...

CERiS

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 ...

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 ...

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 ...

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 ...

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 ...

CERiS

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 · On-site

$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 ...

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Appeals Representative information

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$12

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$50

How much do appeals representative jobs pay per hour?

As of Jul 4, 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 4000 a week without a degree?

Appeals Representatives typically do not earn $4,000 a week without a degree; however, some high-paying sales roles, real estate brokers, or specialized trade jobs like certain construction or technical positions can reach that level with experience and skills. These roles often require strong communication, industry knowledge, or certifications 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 accurately and explain decisions clearly. Attention to detail, knowledge of relevant policies or regulations, and proficiency with case management software are also important for success in this role.

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 or benefits, ensuring compliance with policies and regulations. They analyze case details, communicate decisions to claimants, and may use specialized software to document and track cases throughout the appeals process.

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.

How can I make 2000 a week working from home?

Appeals Representatives working from home can increase earnings by handling a higher volume of cases, improving their communication and negotiation skills, and gaining relevant certifications. Earning $2,000 weekly typically requires consistent full-time hours, efficient case management, and possibly working overtime or taking on additional responsibilities.
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Appeals Representative jobs near you
Appeals Representative (Remote)

Appeals Representative (Remote)

Addison Group

Fort Worth, TX • Remote

$17/hr

Other

Medical, Dental, Vision, Retirement

Posted 2 days ago

Job description

Job Title: Appeals Representative

Location (City, State): Remote

Industry: Healthcare | Revenue Cycle Management | Insurance

Pay: $17.00 / hour + Monthly Performance Bonus (up to $200)

Benefits: This role is eligible for medical, dental, vision and 401k.

About Our Client:

Addison Group is partnering with a growing healthcare organization that specializes in revenue cycle support. Our client is seeking detail-oriented Appeals Representatives to join their remote team and assist with reviewing, processing, and resolving healthcare appeals while ensuring compliance with industry and regulatory standards.

Job Description:

Our client is looking for motivated professionals with healthcare or insurance experience to support the appeals process from intake through setup. This position is ideal for individuals who enjoy investigative work, have strong attention to detail, and are comfortable working independently in a fast-paced remote environment.

Key Responsibilities:

  • Review and evaluate provider appeals and supporting documentation received through multiple communication channels.
  • Accurately initiate and document appeals within internal systems while meeting established turnaround times.
  • Analyze claim information and determine appropriate next steps based on client guidelines and regulatory requirements.
  • Research healthcare claims and supporting documentation to ensure accurate appeal processing.
  • Maintain compliance with HIPAA, CMS regulations, and client policies.
  • Utilize multiple systems and software applications to manage workloads efficiently.
  • Communicate professionally with providers and internal teams regarding appeal status and required documentation.
  • Ensure all records are complete, accurate, and properly documented throughout the appeals process.

Qualifications:

  • At least 1 year of experience in healthcare, medical claims, insurance, revenue cycle, or a related customer service environment.
  • Previous experience handling medical appeals is strongly preferred.
  • Familiarity with medical insurance, explanation of benefits (EOBs), and healthcare claims processing.
  • Knowledge of Medicare, Medicaid, and commercial insurance guidelines is preferred.
  • Understanding of medical terminology, CPT codes, and ICD coding.
  • Strong data entry, organizational, and time management skills with exceptional attention to detail.
  • Proficiency with Microsoft Office and the ability to navigate multiple software applications simultaneously.
  • Excellent written and verbal communication skills.
  • Ability to work independently in a remote environment while consistently meeting productivity and quality goals.

Additional Details:

  • Number of Openings: 2
  • Employment Type: Direct Hire
  • Work Setting: 100% Remote
  • Schedule: Monday-Friday, 8:00 AM-5:00 PM
  • Internet Stipend: $40/month reimbursement
  • Performance Incentive: Eligible for a monthly bonus of up to $200 based on performance metrics.
  • Interview Process: One virtual interview with the hiring manager.
  • Start Date: ASAP

Perks:

  • Fully remote opportunity
  • Monthly performance bonus opportunity
  • Internet reimbursement provided
  • Direct Hire position with long-term career growth potential
  • Collaborative and supportive team environment
  • Opportunity to build experience within healthcare revenue cycle operations 
Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.

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