ZipRecruiter

Log In

1

Medical Appeals Jobs (NOW HIRING)

Globus Medical

Appeals Specialist

Collegeville, PA · On-site

At Globus Medical, we move with a sense of urgency to deliver innovations that improve the quality ... The Patient Access Appeals Specialist is part of the HFX Access team, playing a critical role in ...

OMS MEDICAL BILLING LLC

Appeals Specialist

Addison, TX

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Position Overview OrthoMed Anesthesia seeking a detail-oriented Appeals Specialist to join our fast ... Strong knowledge of medical terminology, CPT, and ICD-10 coding * Familiarity with insurance ...

Varite

Customer Care Representative #

Columbia, SC · On-site

$13 - $17.75/hr

Reviews and adjudicates claims and/or non-medical appeals. * Determines whether to return, deny or pay claims following organizational policies and procedures. * Ensures effective customer relations ...

New

previous pagenext page

Showing results 21-40

All JobsLegal JobsLaw Office and Legal Clinic JobsParalegal JobsMedical Appeals Jobs

Medical Appeals information

See salary details

$11

$22

$40

How much do medical appeals jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for medical appeals in the United States is $22.84, according to ZipRecruiter salary data. Most workers in this role earn between $16.83 and $24.04 per hour, depending on experience, location, and employer.

What are medical appeals?

Medical appeals are formal requests made to a health insurance company when a claim for medical services, treatments, or prescriptions has been denied or only partially approved. Patients, healthcare providers, or authorized representatives can file appeals to have the insurance company review and reconsider its decision. The appeals process often involves submitting additional documentation or medical evidence to support the necessity of the service. Understanding the specific appeals process and deadlines for your insurance provider is crucial for a successful outcome.

What are the key skills and qualifications needed to thrive in medical appeals, and why are they important?

To thrive in Medical Appeals, you need a strong knowledge of medical terminology, insurance policies, and healthcare regulations, often supported by experience in healthcare administration or coding. Familiarity with claims management systems, electronic health records (EHRs), and relevant certifications such as Certified Professional Coder (CPC) or Certified Professional Medical Auditor (CPMA) is typically required. Attention to detail, effective written communication, and problem-solving skills help professionals build persuasive appeals and collaborate with providers or insurers. These skills ensure accurate, timely resolution of denied claims, maximizing reimbursements and supporting patient access to necessary care.

What are some common challenges faced in a medical appeals role, and how can I prepare for them?

Professionals in Medical Appeals frequently encounter challenges such as navigating complex insurance policies, tight deadlines for appeals submissions, and managing high volumes of cases. To succeed, it's important to develop strong organizational skills, attention to detail, and effective communication abilities to advocate for patients and collaborate with healthcare providers. Familiarity with medical terminology, insurance guidelines, and regulatory requirements will also help you build persuasive appeals and respond to denials efficiently. Staying current with changing healthcare regulations and regularly collaborating with teammates can further enhance your effectiveness in this role.

What is the difference between Medical Appeals vs Medical Coding Specialist?

AspectMedical AppealsMedical Coding Specialist
Required CredentialsCertification in medical billing and coding, knowledge of insurance policiesCertification in medical coding (CPC, CCS), understanding of medical terminology
Work EnvironmentHealthcare facilities, insurance companies, billing officesHospitals, clinics, outpatient facilities, insurance companies
Employer & Industry UsageUsed to challenge denied claims, ensure reimbursementUsed to assign accurate medical codes for billing and documentation

Medical Appeals and Medical Coding Specialists both work within the healthcare billing and reimbursement process. Medical Appeals focus on reviewing and contesting denied insurance claims, while Medical Coding Specialists assign appropriate codes to medical procedures and diagnoses. Both roles require certification and knowledge of healthcare documentation, but they serve different functions in the revenue cycle.

More about Medical Appeals jobs

What cities are hiring for Medical Appeals jobs?

Cities with the most Medical Appeals job openings:

What states have the most Medical Appeals jobs?

States with the most job openings for Medical Appeals jobs include:

What job categories do people searching Medical Appeals jobs look for?

The top searched job categories for Medical Appeals jobs are:

Medical Appeals jobs near you
Infographic showing various Medical Appeals job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 15% Part Time, and 7% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $47,512 per year, or $22.8 per hour.

Appeals Representative I

Federal Hearings And Appeals

Wilkes Barre, PA • On-site

$40K - $45K/yr

Full-time

Re-posted yesterday

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