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Remote Appeals Representative Jobs (NOW HIRING)

Humana

Appeals Rep

$48K - $65K/yr

As the Appeals Representative 4 you will * Managed Level 1 appeal cases, ensuring accuracy ... Inventory management experience This is a remote role and will provide coverage for Eastern time ...

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 ... This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Reviews, analyzes, and completes ...

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 ... This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Reviews, analyzes, and completes ...

Corvel

Appeals Representative II

$18.80 - $30.34/hr

The Appeals Representative is responsible for addressing provider inquiries and appeals via email ... This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Reviews, analyzes, and completes ...

CERiS

Appeals Representative II

$18.80 - $30.34/hr

The Appeals Representative is responsible for addressing provider inquiries and appeals via email ... This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Reviews, analyzes, and completes ...

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 ... This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Reviews, analyzes, and completes ...

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 ... This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Reviews, analyzes, and completes ...

Humana, Inc.

Grievances & Appeals Representative

Rico, CO · On-site +1

$34K - $45K/yr

Become a part of our caring community The Grievances & Appeals Representative 3 manages client ... This is a remote position. * Work Schedule: Monday through Friday, 8:00 a.m. to 5:00 p.m.; however ...

Humana

Grievances & Appeals Representative

$34K - $45K/yr

Become a part of our caring community The Grievances & Appeals Representative 3 manages client ... This is a remote position. * Work Schedule: Monday through Friday, 8:00 a.m. to 5:00 p.m.; however ...

MedReview

Appeals Specialist

Manhattan, NY · On-site +1

$50K/yr

Responsibilities This list does not represent all responsibilities for this position. Candidate ... frequent interruptions Remote Work Requirements * High speed internet (100 Mbps per person ...

MedReview

Appeals Specialist

Manhattan, NY · Remote

Responsibilities This list does not represent all responsibilities for this position. Candidate ... frequent interruptions Remote Work Requirements * High speed internet (100 Mbps per person ...

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Remote Appeals Representative information

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How much do remote appeals representative jobs pay per hour?

As of Aug 15, 2026, the average hourly pay for remote 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 is the difference between Remote Appeals Representative vs Remote Customer Service Representative?

AspectRemote Appeals RepresentativeRemote Customer Service Representative
Required CredentialsHigh school diploma or equivalent; some roles may require knowledge of appeals processesHigh school diploma or equivalent; customer service experience often preferred
Work EnvironmentHome-based, handling appeals cases for insurance, healthcare, or government agenciesHome-based, assisting customers with inquiries, billing, and product support
Employer & IndustryInsurance companies, healthcare providers, government agenciesRetail, telecommunications, service providers
Common Search & ComparisonAppeals process, claims review, dispute resolutionCustomer support, help desk, client assistance

The Remote Appeals Representative focuses on reviewing and resolving appeals related to claims or benefits, requiring specific knowledge of appeals procedures. In contrast, the Remote Customer Service Representative handles general customer inquiries and support. Both roles are remote, but they serve different functions within their industries.

What are the key skills and qualifications needed to thrive as a remote appeals representative?

To thrive as a Remote Appeals Representative, you need a solid understanding of healthcare policies, claims processing, and insurance guidelines, often supported by experience in medical billing or a related field. Familiarity with claims management software, electronic health records (EHRs), and proficiency in Microsoft Office Suite are typically required. Exceptional attention to detail, strong written communication, and problem-solving skills help individuals excel in this role. These abilities are crucial for accurately reviewing, processing, and resolving appeals while ensuring compliance and member satisfaction.

How does a remote appeals representative typically collaborate with other departments to resolve complex cases?

As a Remote Appeals Representative, you will frequently interact with departments such as claims processing, medical review, and customer service to gather necessary information and clarify case details. Collaboration often involves virtual meetings, secure messaging, and shared documentation platforms to ensure all stakeholders are aligned and have access to relevant data. This cross-functional teamwork is essential for resolving complex or escalated appeals efficiently while maintaining compliance with company and regulatory standards.

What does a remote appeals representative do?

A Remote Appeals Representative reviews and processes appeals from customers, often related to insurance claims, billing disputes, or service denials. They work from a remote location, communicating with clients, healthcare providers, or other stakeholders to gather necessary information and documentation. Their primary role is to assess the validity of appeals, ensure compliance with company policies and regulations, and provide clear resolutions. Attention to detail, strong communication skills, and knowledge of relevant laws and procedures are essential for this job.

What cities are hiring for Remote Appeals Representative jobs?

Cities with the most Remote Appeals Representative job openings:

What are the most commonly searched types of Appeals Representative jobs?

The most popular types of Appeals Representative jobs are:

What states have the most Remote Appeals Representative jobs?

States with the most job openings for Remote Appeals Representative jobs include:

Remote Appeals Representative jobs near you

Appeals Representative (Remote)

Addison Group

Fort Worth, TX • Remote

$17/hr

Other

Medical, Dental, Vision, Retirement

Re-posted 14 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.

#HC1