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Insurance Appeals Jobs in Florida (NOW HIRING)

CVAK MSO, LLC

Authorization/Referral Specialist

Kissimmee, FL · On-site

$16 - $21.25/hr

Stay updated on insurance industry changes and guidelines for authorization processes. 6. Insurance Appeals: Assist in the insurance appeals process for denied authorizations. Gather additional ...

Terlep Chiropractic

Medical Biller

Spring Hill, FL · On-site

$20 - $22/hr

Submit corrected claims, appeals, and supporting documentation as needed. * Post insurance and patient payments accurately. * Review Explanation of Benefits (EOBs) and Electronic Remittance Advices ...

Gastromed, LLC

Infusion Center Coordinator

Miami, FL · On-site

$49K - $70K/yr

Insurance appeals preparation, submission, and follow-up Qualifications * High School Diploma required; Associate degree preferred * Experience in a healthcare setting related to insurance ...

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Insurance Appeals information

What are insurance appeals?

Insurance appeals are formal requests made to an insurance company to reconsider and potentially overturn a denied claim or coverage decision. When an insurance provider refuses to pay for a service or treatment, policyholders or healthcare providers can submit an appeal with supporting documentation to argue why the claim should be approved. The appeals process typically involves several steps and may require detailed medical records, letters from healthcare professionals, and a clear explanation of why the original decision should be reversed.

What are the key skills and qualifications needed to thrive in insurance appeals?

To thrive in Insurance Appeals, you need a solid understanding of insurance policies, claims processes, medical terminology, and relevant regulations, often supported by experience in healthcare administration or a related field. Familiarity with claims management software, electronic health records (EHRs), and knowledge of HIPAA compliance are typically required. Strong analytical skills, attention to detail, and effective written and verbal communication set outstanding professionals apart. These skills are crucial for efficiently navigating complex appeals, ensuring compliance, and achieving positive outcomes for clients or organizations.

What are some common challenges faced in an insurance appeals role, and how can they be managed?

Professionals in Insurance Appeals often encounter challenges such as navigating complex policy guidelines, handling tight deadlines, and managing extensive documentation requirements. Staying organized and up-to-date on insurance regulations is essential to ensure accurate and timely submissions. Collaborating closely with medical providers, patients, and insurance representatives can help clarify information and strengthen appeal cases. Effective time management and clear communication are key to overcoming these challenges and achieving successful outcomes.

What are popular job titles related to Insurance Appeals jobs in Florida?

For Insurance Appeals jobs in Florida, the most frequently searched job titles are:

What job categories do people searching Insurance Appeals jobs in Florida look for?

The top searched job categories for Insurance Appeals jobs in Florida are:

What cities in Florida are hiring for Insurance Appeals jobs?

Cities in Florida with the most Insurance Appeals job openings:

Insurance Appeals jobs near you
Infographic showing various Insurance Appeals job openings in Florida as of August 2026, with employment types broken down into 100% Full Time. Highlights an 84% In-person, and 16% Remote job distribution.

Appeals Specialist I

ROM Technologies, Inc.

Clearwater, FL • On-site

$20 - $23/hr

Full-time

Re-posted 13 days ago

Job description

JOB DESCRIPTION
Approved Opening Statement
At ROMTech, we are transforming rehabilitation through innovative technology and exceptional patient support. We are committed to helping patients achieve better outcomes through Clinician guided at-home rehab while delivering an outstanding experience throughout their recovery journey.
ROMTech is a medical technology company that has created and patented a revolutionary medical device and telemedical platform which delivers in-home rehabilitative care. Our disruptive technology has proven to yield faster recoveries and better outcomes with unmatched patient compliance. We began in orthopedics and have entered scale-up of our orthopedic business. We are now leveraging our core technology, infrastructure, and first mover position to enter cardiology, followed by other adjacent markets. Having created this new lane, we have a unique opportunity to serve as the global leader in the business, technology, and science of recovery, and to bring life-changing help to many millions of people.
Position Title: Appeals Specialist
Department: Revenue Cycle Management
Reports To: Appeals Manager
Location / Work Environment: Office Environment
Worker Classification: W-2 Employee
FLSA Status: Non-Exempt
Job Level: Standard
Job Purpose
The Appeals Specialist plays a critical role in supporting ROMTech's revenue cycle by ensuring timely, accurate, and compliant resolution of denied insurance claims. This role directly contributes to the organization's financial performance and patient access to care by optimizing reimbursement outcomes and maintaining adherence to payer guidelines. The position supports the delivery of Clinician guided at-home rehab by ensuring claims related to ROMTech devices are appropriately reviewed, appealed, and processed.
Key Responsibilities
Essential Duties
  • Review and analyze denied insurance claims to determine appropriate appeal strategies.
  • Prepare, submit, and track appeals in accordance with payer-specific requirements and established timelines.
  • Collaborate cross-functionally with billing, coding, and clinical teams to obtain supporting documentation for appeals.
  • Interpret Explanation of Benefits (EOBs), payer policies, and reimbursement guidelines to support appeal decision-making.
  • Monitor appeal status and proactively follow up on unresolved, pending, or outstanding claims.
  • Maintain accurate and detailed records of appeals activity within designated system platforms.
  • Ensure compliance with payer regulations, internal policies, HIPAA requirements, and healthcare reimbursement standards.
  • Prioritize and manage multiple appeals cases while meeting established productivity and quality expectations.
  • Research payer requirements and identify opportunities to improve reimbursement outcomes.
  • Communicate effectively with insurance carriers and internal stakeholders regarding appeal status and resolution.
Other Functions
  • Support process improvement initiatives within the Revenue Cycle Management department.
  • Assist with reporting, audits, and reconciliation activities related to claims and appeals.
  • Provide general administrative support to the Revenue Cycle Management team as needed.
  • Participate in departmental meetings, training sessions, and professional development activities.
  • Performs other related duties as assigned to support operational and business needs.

JOB QUALIFICATIONS
Skills and Abilities
Required
  • Excellent written and verbal communication skills.
  • Strong analytical and problem-solving abilities.
  • Ability to work independently and manage multiple priorities.
  • High attention to detail and accuracy.
  • Ability to interpret insurance guidelines, payer policies, and reimbursement requirements.
  • Proficiency with computer systems and claims or appeals tracking tools.
  • Strong organizational and time-management skills.
  • Ability to maintain confidentiality and handle sensitive information appropriately.
Preferred
  • Familiarity with medical device billing and reimbursement processes.
  • Experience with revenue cycle management systems or EHR platforms.
  • Knowledge of payer-specific appeal strategies and regulatory requirements.
  • Understanding of Medicare, Medicaid, and commercial insurance reimbursement processes.
Work Experience Requirements
Required
  • Experience in medical billing, claims processing, insurance follow-up, or revenue cycle management.
Preferred
  • Experience in a medical device, healthcare, or provider organization.
  • Prior experience managing insurance appeals and denial resolutions.
  • Experience working with multiple payer types and reimbursement methodologies.
Education Requirements
Required
  • None.
Preferred
  • High school diploma or equivalent.
License and Certification Requirements
Required
  • None.
Preferred
  • Certified Professional Coder (CPC).
  • Certified Coding Specialist (CCS).
  • Certified Revenue Cycle Representative (CRC) or similar coding, billing, or revenue cycle certification.
Physical Demands and Working Conditions
Office Environment
The following describes the physical demands and work environment characteristics required to perform the essential functions of this position. These requirements are representative of those an employee may encounter while performing the job and are not intended to be an exhaustive list. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the role.
  • Ability to sit at a computer terminal for an extended period.
  • Moderate noise (i.e., phone calls, online meetings, computer audio).
  • While performing the duties of this job, the employee may be regularly required to stand, sit, talk, hear, reach, stoop, kneel, and use hands and fingers to operate a computer, telephone, and keyboard.
  • Specific vision abilities required by this job include close vision requirements due to computer work.
  • Regular, predictable attendance is required.
  • Must be able to communicate clearly and professionally in both verbal and written formats.
  • Must be able to engage in active listening and express ideas effectively in person, by phone, and via virtual meetings.
  • The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Reasonable accommodation requests must be made in writing by emailing people@romtech.com.

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