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Remote Appeals Representative Jobs (NOW HIRING)

MedReview

Appeals Specialist II

Manhattan, NY · On-site +1

$50K - $55K/yr

... represent all responsibilities for this position. Candidate must understand and be willing and able ... frequent interruptions Remote Work Requirements * High speed internet (100 Mbps per person ...

MedReview

Appeals Specialist II

Manhattan, NY · Remote

... represent all responsibilities for this position. Candidate must understand and be willing and able ... frequent interruptions Remote Work Requirements * High speed internet (100 Mbps per person ...

WellSense Health Plan

Appeals and Grievance Specialist

$48K - $70K/yr

Our Investment in You: · Full-time remote work · Competitive salaries · Excellent benefits Key ... representatives from external vendors · Determines and designs appeal processing schedule and ...

Avēsis

Appeals and Grievances Coordinator

$22.50 - $28/hr

Collaborative: ability to represent your own interests while being fair to those representing other ... As this role is a remote role, you are required to maintain internet service that allows you to ...

UHS

MARKET APPEALS SPECIALIST

Brentwood, TN · Remote

This is a fully remote position. RESPONSIBILITIES: * Complete all standard appeals timely and ... Strong oral communication skills to represent patient progress and treatment in behavioral health.

New

Avesis

Appeals and Grievances Coordinator

Phoenix, AZ · Remote

$21.25 - $26.25/hr

Collaborative: ability to represent your own interests while being fair to those representing other ... As this role is a remote role, you are required to maintain internet service that allows you to ...

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Remote Appeals Representative information

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How much do remote appeals representative jobs pay per hour?

As of Jun 12, 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.

How to make 2000 a week working from home?

A Remote Appeals Representative can potentially earn $2,000 weekly by handling a high volume of cases, maintaining efficiency, and gaining experience in appeals processes. Increasing income may involve working additional hours, improving communication skills, and utilizing relevant tools like case management software. Achieving this level of income typically requires consistent performance and possibly specialized training or certifications.

What is the meaning of the word remote?

In the context of a Remote Appeals Representative, the term 'remote' refers to performing job duties outside of a traditional office setting, often from home or another location of the employee's choice. This setup typically requires good communication skills and familiarity with digital tools such as email and case management software.

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, and why are they important?

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.

What is the meaning of remote in one word?

In the context of a Remote Appeals Representative job, 'remote' means working outside a traditional office setting, typically from home or another location of choice. It involves using communication tools like email and phone to perform duties without being physically present at a company's office.

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 is the best remote control for Alzheimer's patients?

A Remote Appeals Representative does not typically provide recommendations for remote controls for Alzheimer's patients. However, simplified remote controls with large buttons, clear labels, and minimal functions are often recommended to help individuals with cognitive impairments manage their devices more easily. Caregivers and healthcare professionals should assess individual needs to select appropriate tools and ensure safety.
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 Professional

Appeals Professional

TMF Health Quality Institute

Austin, TX • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 4 days ago

Job description

**Please make sure your application is complete, including your education, employment history, and any other applicable sections. Initial screening is based on the minimum requirements as defined in the job posting, such as education, experience, licenses, and certifications. Your experience should also address the knowledge, skills and abilities needed for the role. Incomplete applications will not be considered.**
*This position is located Remote United States*
*This position requires working weekends, and rotating holidays as needed *
*Please note the start date is on or after July 6, 2026*
Position Purpose:
Provides dissatisfied parties to a Medicare appeal the opportunity to present documentation or evidence to demonstrate why an appeal should be allowed. Provides an independent second level determination based on the documentation, facts, laws, regulations, and guidelines.
Essential Responsibilities:
  • Reviews medical records/case file, writes a decision that is clear, concise, and impartial and supports the determination made, and documents review.
  • Makes sound, independent decisions based on medical evidence in accordance with statutes, regulation, rulings, and policy.
  • Responds to and ensures that all issues raised by the beneficiary, representative, supplier, and provider have been addressed.
  • Provides a fair and impartial decision based on current evidence, regulations, policies, and procedures.
  • Conducts research using online federal regulations, contract policy, standards of medical practice, contract manuals, coverage issues manuals, medical literature, and other related resources to complete an accurate and well-supported decision.

Minimum Qualifications
Education
  • Associate's degree or 60 or more credit hours towards a Bachelor's degree from an accredited college or university in healthcare or related discipline
    • Additional experience in Medicare appeals, medical review, clinical, or other related experience in a healthcare setting may be substituted for Associate's degree on a year per year basis. (Experience requirements may be satisfied by full-time experience or the prorated part-time equivalent.)

Experience
  • One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting
  • Medicare Part C related appeals activities, preferred
  • Resided in the United States for a minimum of three (3) years out of the last five (5) years (Per Contract Requirement)

Benefits
C2C offers an excellent benefits package, including:
  • Medical, dental, vision, life, accidental death and dismemberment, and short and long-term disability insurance
  • Section 125 plan
  • 401K
  • Competitive salary
  • License/credentials reimbursement
  • Tuition Reimbursement

EOE Vet/Disability
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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