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Remote Medicare Appeals Jobs (NOW HIRING)

CVS Health

Medical Director - Medicare Appeals

$174K - $374K/yr

This is a remote based (work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Medicare Appeals: * Direct daily work on part C appeals (both provider ...

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Remote Medicare Appeals information

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How much do remote medicare appeals jobs pay per hour?

As of Sep 5, 2026, the average hourly pay for remote medicare appeals in the United States is $25.71, according to ZipRecruiter salary data. Most workers in this role earn between $19.71 and $30.53 per hour, depending on experience, location, and employer.

What is a remote Medicare appeals specialist?

A Remote Medicare Appeals Specialist is a professional who works from home or another remote location to handle the appeals process for Medicare claims that have been denied or disputed. Their responsibilities include reviewing denied claims, gathering supporting documentation, communicating with healthcare providers and patients, and submitting appeals to Medicare or related agencies. They must have a strong understanding of Medicare regulations and guidelines, as well as attention to detail and strong communication skills. This role is commonly found in hospitals, insurance companies, and third-party billing services seeking to ensure proper reimbursement for healthcare services.

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

To thrive as a Remote Medicare Appeals Specialist, you need in-depth knowledge of Medicare regulations, claims processing, and appeals procedures, typically supported by experience in healthcare administration or medical billing. Familiarity with claims management software, electronic health record (EHR) systems, and regulatory databases is essential. Strong analytical skills, attention to detail, and effective written and verbal communication are critical soft skills in this role. These abilities ensure accurate review and resolution of appeals, compliance with complex guidelines, and clear communication with providers and beneficiaries.

What are some common challenges faced by professionals working in remote Medicare appeals, and how can they be effectively managed?

Professionals in remote Medicare appeals often encounter challenges such as navigating complex regulations, managing high caseloads, and communicating efficiently with healthcare providers and beneficiaries. Staying updated with frequently changing CMS guidelines is crucial to ensure accurate and timely submissions. Effective time management, strong attention to detail, and regular communication with team members help overcome these challenges and maintain a high standard of work. Utilizing secure, reliable digital tools and participating in ongoing training can also streamline remote workflows and improve outcomes.

What is the difference between Remote Medicare Appeals vs Remote Medicare Customer Service Representative?

AspectRemote Medicare AppealsRemote Medicare Customer Service Representative
Required CredentialsKnowledge of Medicare policies, certification in appeals processes often preferredCustomer service skills, basic Medicare knowledge, sometimes certification
Work EnvironmentHome-based, office setting, healthcare or insurance companyHome-based, call center or insurance provider environment
Employer & Industry UsageInsurance companies, healthcare providers, government agenciesInsurance companies, healthcare providers, customer support centers
Search & Comparison IntentUnderstanding appeals process, specialized role in claims resolutionGeneral customer support, billing, and account inquiries

Remote Medicare Appeals specialists focus on reviewing and resolving denied Medicare claims, requiring specific knowledge of appeals procedures. In contrast, Remote Medicare Customer Service Representatives handle general inquiries, billing, and customer support related to Medicare. Both roles are home-based and serve the healthcare insurance industry, but they differ in responsibilities and required expertise.

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The most popular types of Medicare Appeals jobs are:

What states have the most Remote Medicare Appeals jobs?

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

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The top searched job categories for Remote Medicare Appeals jobs are:

Remote Medicare Appeals jobs near you
Infographic showing various Remote Medicare Appeals job openings in the United States as of August 2026, with employment types broken down into 85% Full Time, 5% Part Time, and 10% Contract. Highlights an 100% Remote job distribution, with an average salary of $53,482 per year, or $25.7 per hour.

Appeals Intake Coordinator (Medicare Appeals & Grievances) â Remote

A-Line Staffing Solutions

Grand Rapids, MI • Remote

$22 - $28/hr

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Title: Appeals Intake Coordinator (Medicare Appeals & Grievances) – Remote Location: Remote (Michigan-based preferred; aligned to Grand Rapids, MI 49525) Schedule: Full-Time | Monday–Friday (standard business hours) Pay: $22.00–$28.00/hr Summary Remote (Michigan-based preferred; aligned to Grand Rapids, MI 49525) Hiring an Appeals Intake Coordinator for a fully remote role focused on Medicare appeals and grievances intake. This Appeals Intake Coordinator will review incoming member and provider complaints, screen for urgency and type of issue, and route cases to the appropriate analyst for resolution. Ideal for candidates with managed care experience who are detail-driven, fast in a queue environment, and strong in written documentation and professional correspondence.

Responsibilities

Remote (Michigan-based preferred; aligned to Grand Rapids, MI 49525) Review, screen, and triage incoming Medicare appeals and grievances based on urgency and concern type Assign complaints/appeals to the correct analyst and maintain accurate intake documentation Support investigations by gathering documentation, tracking items, and assisting with correspondence as needed Communicate with members, providers, and regulatory entities regarding actions, decisions, and required information Partner with internal teams (Customer Service, Utilization Management, clinical leadership) to coordinate next steps Participate in quality monitoring, auditing, and workflow improvement activities Maintain strict HIPAA compliance and accurate handling of protected health information (PHI) Work independently while meeting productivity, accuracy, and turnaround expectations in a high-volume environment Qualifications Remote (Michigan-based preferred; aligned to Grand Rapids, MI 49525) High School Diploma or GED (required) 1+ year experience in health insurance / managed care performing Appeals & Grievances functions (required) Strong written communication, organization, and time management skills Ability to prioritize quickly and stay accurate in changing, fast-paced queues Proficiency with Microsoft Office (Outlook, Word, Excel) Preferred: exposure to HealthEdge, Epic, and/or Facets Comfortable working remotely with consistent attendance and high attention to detail

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About A-Line Staffing Solutions

Sourced by ZipRecruiter

A-Line Staffing Solutions is an established full-service recruiting and staffing provider that operates in the industry of human resources and recruitment. Based in Utica, Michigan, A-Line Staffing Solutions has been committed to its mission of providing innovative and effective workforce solutions since its foundation. The company specializes in providing high-quality staffing solutions for a range of disciplines, including Information Technology, Professional, Administrative, Healthcare, and more. A-Line prides itself on its ability to offer comprehensive and tailored staffing solutions in line with the varying needs of different businesses, which has played a crucial role in the company's growth and success.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Utica, MI, US

Year founded

2004

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