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Per Diem Appeals Representative Jobs (NOW HIRING)

PFS Group

Insurance Appeals Rep

Houston, TX · On-site

The Appeals Representative will be responsible for reviewing basic clinical documentation and ... Meet minimum of 10 appeals per day, as well as any follow-up needed on existing appeals.

Humana

Grievance & Appeals Representative

$40K - $52K/yr

The Grievances & Appeals Representative 2 performs varied activities and moderately complex ... per week) employment at the time of posting. The pay range may be higher or lower based on ...

New

PFS Group

Insurance Appeals Rep

Houston, TX

The Appeals Representative will be responsible for reviewing basic clinical documentation and ... Meet minimum of 10 appeals per day, as well as any follow-up needed on existing appeals.

Humana

Grievance & Appeals Representative

$40K - $52K/yr

The Grievances & Appeals Representative 2 performs varied activities and moderately complex ... per week) employment at the time of posting. The pay range may be higher or lower based on ...

New

Humana

Grievance & Appeals Representative

$40K - $52K/yr

The Grievances & Appeals Representative 2 performs varied activities and moderately complex ... per week) employment at the time of posting. The pay range may be higher or lower based on ...

New

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 ... Pay Range: $20.08 - $30.06 per hour A list of our benefit offerings can be found on our CorVel ...

CERiS

Appeals Representative II

Fort Worth, TX · Remote

$20.08 - $30.06/hr

The Appeals Representative is responsible for reviewing, analyzing, and addressing provider ... Pay Range: $20.08 - $30.06 per hour A list of our benefit offerings can be found on our CorVel ...

CERiS

Appeals Representative II

$18.80 - $30.34/hr

The Appeals Representative is responsible for addressing provider inquiries and appeals via email ... Pay Range: $18.80 - $30.34 per hour A list of our benefit offerings can be found on our CorVel ...

Corvel

Appeals Representative II

Fort Worth, TX · Remote

$20.08 - $30.06/hr

The Appeals Representative is responsible for reviewing, analyzing, and addressing provider ... Pay Range: $20.08 - $30.06 per hour A list of our benefit offerings can be found on our CorVel ...

Corvel

Appeals Representative II

$18.80 - $30.34/hr

The Appeals Representative is responsible for addressing provider inquiries and appeals via email ... Pay Range: $18.80 - $30.34 per hour A list of our benefit offerings can be found on our CorVel ...

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 ... Pay Range: $20.08 - $30.06 per hour A list of our benefit offerings can be found on our CorVel ...

CERiS

Appeals Representative II

$18.80 - $30.34/hr

The Appeals Representative is responsible for addressing provider inquiries and appeals via email ... Pay Range: $18.80 - $30.34 per hour A list of our benefit offerings can be found on our CorVel ...

Corvel

Appeals Representative II

$18.80 - $30.34/hr

The Appeals Representative is responsible for addressing provider inquiries and appeals via email ... Pay Range: $18.80 - $30.34 per hour A list of our benefit offerings can be found on our CorVel ...

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 ... Pay Range: $18.80 - $30.34 per hour A list of our benefit offerings can be found on our CorVel ...

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 ... Pay Range: $18.80 - $30.34 per hour A list of our benefit offerings can be found on our CorVel ...

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 ... Pay Range: $18.80 - $30.34 per hour A list of our benefit offerings can be found on our CorVel ...

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 ... Pay Range: $18.80 - $30.34 per hour A list of our benefit offerings can be found on our CorVel ...

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 ... Pay Range: $20.08 - $30.06 per hour A list of our benefit offerings can be found on our CorVel ...

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As of Aug 16, 2026, the average hourly pay for per diem 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.

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Per Diem Appeals Representative jobs near you

Insurance Appeals Rep

PFS Group

Houston, TX • On-site

Full-time

Medical, Dental, Vision, Life, Retirement

Re-posted 22 hours ago

Job description

JOB SUMMARY
Under the supervision of the Insurance Supervisor, the Insurance Appeals Representative will work high dollar or complex denials for hospital insurance claims. The Appeals Representative will be responsible for reviewing basic clinical documentation and relevant payer guidelines to draft timely and effective appeals. They will be measured on appeals success and denials overturn rate, working to improve cash collections on behalf of their client(s). The Appeals Representative may directly write appeals or act as a consultant for other Insurance Reps, assisting them with referencing clinical or payer guidelines. They may be expected to share payer updates with Insurance teams or provide occasional information sessions to department trainer or representatives. They will prioritize work based on feedback from their leadership in order to best impact performance metrics.
ESSENTIAL FUNCTIONS
  1. Demonstrate extensive knowledge of insurance follow-up and denials.
  2. Act as the subject matter expert for appeals on their team.
  3. Triage and determine denial reasons from remittance advice, explanation of benefits, payer portals, or other avenues of information.
  4. Research pertinent payer medical policy bulletins and billing guidelines, creating a repository of reference materials for themselves and other team members.
  5. Prioritize work effort by viability and amount of payment to maximize cash.
  6. Track payer issues and escalations to provide relevant trending information to leadership.
  7. Follow appeals to resolution to assess effectiveness.
  8. Create job aids and share information on appeals language as needed.
  9. Practice compliant billing and follow-up strategies for all government and managed care payers.
  10. Meet minimum of 10 appeals per day, as well as any follow-up needed on existing appeals.
  11. Aggressively seek to resolve unpaid balances.
  12. Document all efforts accurately and thoroughly.
  13. Follow all workflow protocols.
  14. Work other insurance inventory as assigned or as volume demands.

KNOWLEDGE, SKILLS, AND ABILITIES
  1. Outstanding research and follow-up skills.
  2. Deep knowledge of denial types and causes.
  3. Ability to research commercial, managed care, and government payer guidelines and reference language in all appeals.
  4. Ability to read and interpret remittance advice/explanation of benefits.
  5. Strong written and verbal communication skills, especially when drafting appeals or creating workflow templates for teammates.
  6. Self-motivation and ability to work autonomously.
  7. Basic analytics, to include Microsoft Excel.

EDUCATION AND EXPERIENCE
  1. At least 6 months as an Insurance Representative at PFS Group, or 12 months of equivalent experience from a comparable organization.
  2. At least 2 years of hospital insurance follow-up or denials experience.
  3. Epic experience, with strong preference toward HB, required.

Preferences
  1. CUBS experience

PFS Group
Nationwide Patient Account Management Firm.
Based in Houston, Texas, we currently work with 32+ clients who operate more than 100 hospital facilities from small, rural community medical centers to metro population center health systems. Leaders in their respective markets and nationwide, our clients rely on our services to support their accounts receivable departments.
PFS Group offers a friendly, caring work environment, with competitive benefits and compensation, (medical, dental, vision, short and long-term disability, life insurance, hospital indemnity, critical illness, accident insurance and a matching 401(k) and Zayzoon!
If you are looking for a position in a dynamic, fast-paced organization with career growth opportunities, come grow with us! www.pfsgroup.org

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