ZipRecruiter

Log In

2

Remote Appeals Jobs in Florida (NOW HIRING)

Imagenet

Claims Examiner - Remote

Tampa, FL · Remote

Review and investigate provider dispute requests, appeals, and reconsiderations related to ... Remote work offered * Equipment provided * Paid trainingto set you up for success * Comprehensive ...

Imagenet

Claims Examiner - Remote

Tampa, FL · On-site +1

Review and investigate provider dispute requests, appeals, and reconsiderations related to ... Remote work offered * Equipment provided * Paid training to set you up for success * Comprehensive ...

next page

Showing results 1-20

All JobsAppeals JobsRemote Appeals JobsRemote Appeals Jobs in Florida

Remote Appeals information

See Florida salary details

$22.8K

$64.6K

$86.3K

How much do remote appeals jobs pay per year?

As of Aug 24, 2026, the average yearly pay for remote appeals in Florida is $64,626.00, according to ZipRecruiter salary data. Most workers in this role earn between $49,700.00 and $73,600.00 per year, depending on experience, location, and employer.

What is a remote appeals?

A Remote Appeals job involves reviewing and processing appeals related to denied claims, decisions, or disputes, typically in industries like healthcare, insurance, or financial services. Professionals in this role analyze appeal cases, gather necessary documentation, and communicate with relevant parties to ensure fair resolutions. They often work remotely, using digital tools to assess appeals, follow regulations, and meet deadlines. Strong attention to detail, knowledge of industry policies, and communication skills are essential for success in this role.

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

To thrive as a Remote Appeals professional, you need expertise in reviewing and processing appeals, a solid understanding of compliance or regulatory guidelines, and relevant industry experience, often in insurance, healthcare, or legal fields. Familiarity with case management software, document management systems, and standard office tools like Microsoft Office or Google Workspace is essential. Strong analytical abilities, attention to detail, effective written communication, and problem-solving skills help you stand out in this position. These capabilities ensure accurate, efficient appeal resolution and positive experiences for clients or claimants in a remote work environment.

What are typical challenges faced by remote appeals professionals, and how do teams address them?

Remote Appeals professionals often navigate complex regulations, tight deadlines, and high volumes of cases, which can be challenging without direct, in-person team support. Teams typically address these by using structured workflows, regular video meetings, and clear communication channels to ensure consistency and collaboration. Many employers provide comprehensive training and accessible digital resources to help remote staff stay updated on policies and best practices. By fostering a supportive virtual environment, organizations help Remote Appeals specialists efficiently manage their caseloads and maintain high-quality work standards.

What are the most commonly searched types of Appeals jobs in Florida?

The most popular types of Appeals jobs in Florida are:

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

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

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

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

What cities in Florida are hiring for Remote Appeals jobs?

Cities in Florida with the most Remote Appeals job openings:

Remote Appeals jobs near you
Infographic showing various Remote Appeals job openings in Florida as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $64,626 per year, or $31.1 per hour.

Manager, Clinical Appeals

Cooper City, FL • Remote

Health Business Solutions LLC
Health Care and Social Assistance • 51 - 200 employees
Learn more about Health Business Solutions LLCexternal

Full-time

Re-posted 12 days ago

Job description

Job Summary:

We are seeking an experienced and highly organized Manager of Clinical Appeals to lead our clinical appeals operations across commercial and government payers. This role is responsible for overseeing day-to-day activities of clinical appeal specialists, managing appeal strategy execution, ensuring quality and compliance, and meeting client-specific performance goals.

The ideal candidate brings a strong background in clinical review, medical necessity denials, payer appeal processes, and team leadership—ideally across both U.S. and offshore teams (e.g., Philippines). This position is critical to ensuring timely and effective resolution of denied claims, supporting revenue recovery efforts, and maintaining payer and regulatory compliance.

Key Responsibilities:

  • Manage the full-cycle clinical appeals process across multiple payer types, with a focus on government (e.g., Medicare, Medicaid) and commercial payers.
  • Lead and support a team of nurses, clinical reviewers, and appeal specialists—including potential offshore (Philippines-based) staff.
  • Monitor appeal workloads, productivity, and turnaround times to ensure all appeal deadlines and client service level agreements (SLAs) are met.
  • Review and approve complex or high-value clinical appeal cases, ensuring clinical accuracy and compliance with payer guidelines.
  • Maintain up-to-date knowledge of medical necessity criteria, payer policies, NCDs/LCDs, and applicable CMS regulations.
  • Train new and existing team members on clinical guidelines, appeal writing standards, and regulatory requirements.
  • Work cross-functionally with audit, legal, compliance, and operations teams to align on strategy and escalate trends or systemic payer issues.
  • Identify and implement process improvements to increase efficiency, reduce denials, and improve overturn rates.
  • Support the creation and refinement of appeal templates, clinical arguments, and documentation standards.
  • Generate and deliver performance and quality reports to leadership, identifying risks and opportunities for improvement.

Qualifications:

  • Registered Nurse (RN) or clinical degree required; Bachelor's degree in Nursing, Health Administration, or related field preferred.
  • 5+ years of experience in clinical appeals, utilization review, or medical necessity denials.
  • 2+ years in a leadership or supervisory role, preferably within a revenue cycle or payer appeals setting.
  • In-depth understanding of payer denial processes, especially Medicare Advantage, Medicaid Managed Care, and commercial plans.
  • Experience managing remote and/or offshore teams (Philippines experience preferred).
  • Strong working knowledge of ICD-10, CPT, and HCPCS coding as they relate to clinical justifications.
  • Excellent writing skills and the ability to clearly communicate complex clinical reasoning.
  • Familiarity with appeal submission portals, EHRs, and workflow platforms.
  • Knowledge of HIPAA, CMS, and NCQA standards.

Apply