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Senior Appeals Representative Jobs (NOW HIRING)

CERiS

Appeals Representative II

Fort Worth, TX · Remote

$20.08 - $30.06/hr

The Appeals Representative is responsible for reviewing, analyzing, and addressing provider ... For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level ...

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 ... For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level ...

CERiS

Appeals Representative II

$18.80 - $30.34/hr

The Appeals Representative is responsible for addressing provider inquiries and appeals via email ... For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level ...

Corvel

Appeals Representative II

$18.80 - $30.34/hr

The Appeals Representative is responsible for addressing provider inquiries and appeals via email ... For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level ...

Corvel

Appeals Representative II

Fort Worth, TX · Remote

$20.08 - $30.06/hr

The Appeals Representative is responsible for reviewing, analyzing, and addressing provider ... For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level ...

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 ... For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level ...

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 ... For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level ...

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 ... For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level ...

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 ... For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level ...

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 ... For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level ...

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 ... For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level ...

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Senior Appeals Representative information

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How much do senior appeals representative jobs pay per hour?

As of Jul 26, 2026, the average hourly pay for senior 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 are the key skills and qualifications needed to thrive as a Senior Appeals Representative, and why are they important?

To thrive as a Senior Appeals Representative, you need strong analytical skills, in-depth knowledge of insurance regulations, and experience in claims processing, often supported by a bachelor’s degree or equivalent work history. Familiarity with claims management systems, Microsoft Office Suite, and sometimes certification in medical billing or coding is typically required. Excellent communication, attention to detail, and problem-solving abilities help you effectively resolve complex appeals and collaborate with stakeholders. These skills are crucial for ensuring accurate and timely resolution of appeals, maintaining compliance, and supporting customer satisfaction.

What are some common challenges faced by Senior Appeals Representatives, and how can they be effectively managed?

Senior Appeals Representatives often encounter challenges such as handling complex cases that require thorough knowledge of healthcare policies and regulations, managing high caseloads, and navigating tight deadlines. Staying organized and continuously updating one's knowledge on industry changes are crucial for success. Collaboration with clinical staff and other departments is essential to gather necessary information and resolve appeals efficiently. Proactive communication and attention to detail also help ensure appeals are processed accurately and timely, which can lead to better outcomes for both the company and its clients.

What does an appeal specialist do?

A senior appeals representative reviews and investigates denied claims or requests for reconsideration, ensuring compliance with policies and regulations. They communicate with claimants, gather necessary documentation, and make decisions to approve or deny appeals, often using specialized case management systems. Strong analytical skills and knowledge of relevant guidelines are essential for this role.

What skills do you need to be an appeals specialist?

An appeals specialist, such as a Senior Appeals Representative, needs strong communication and analytical skills to review and resolve complex cases. Attention to detail, knowledge of relevant policies or regulations, and proficiency with case management systems are also essential for success in this role.

What is the difference between Senior Appeals Representative vs Appeals Coordinator?

AspectSenior Appeals RepresentativeAppeals Coordinator
Required CredentialsHigh school diploma or equivalent; experience in appeals processes; strong communication skillsHigh school diploma or equivalent; basic understanding of appeals procedures; organizational skills
Work EnvironmentCustomer service settings, insurance companies, healthcare organizationsAdministrative offices, healthcare facilities, insurance providers
Employer & Industry UsageCommon in healthcare, insurance, and government sectorsUsed across similar industries for managing appeals processes
Comparison Search IntentUnderstanding senior-level responsibilities in appealsLearning about coordination and administrative support roles

The Senior Appeals Representative typically handles complex appeals, requiring more experience and advanced communication skills. In contrast, the Appeals Coordinator focuses on organizing and supporting the appeals process, often with less experience required. Both roles are vital in healthcare and insurance industries, but the Senior Appeals Representative usually manages higher-level cases and decision-making.

What is the highest paying job in customer service?

Senior Appeals Representatives can earn higher salaries within customer service, especially when handling complex cases or working in specialized industries like healthcare or finance. Advanced roles often require strong communication skills, industry knowledge, and sometimes certifications, leading to higher compensation compared to entry-level positions.

What does an appeals representative do?

An appeals representative reviews and processes appeals related to denied claims or benefits, ensuring compliance with policies and regulations. They analyze case details, communicate decisions to claimants, and may use specialized software to document and track appeal statuses.

What does a Senior Appeals Representative do?

A Senior Appeals Representative is responsible for reviewing and processing appeals related to insurance claims, benefits, or coverage decisions. They analyze complex cases, evaluate supporting documentation, and communicate with policyholders, providers, and other stakeholders to ensure fair outcomes. These professionals often work with regulatory guidelines to resolve escalated or disputed claims and may mentor junior staff members. Their goal is to ensure appeals are handled efficiently, accurately, and in compliance with company policies and industry regulations.
What cities are hiring for Senior Appeals Representative jobs? Cities with the most Senior 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 Senior Appeals Representative jobs? States with the most job openings for Senior Appeals Representative jobs include:
Senior Appeals Representative jobs near you
Appeals Representative II

Appeals Representative II

CERiS

Fort Worth, TX • Remote

$20.08 - $30.06/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 29 days ago

Job description

The Appeals Representative is responsible for reviewing, analyzing, and addressing provider inquiries and appeals via email, fax, telephone, or written correspondence in accordance with regulatory guidelines, client policy and instructions, and industry standards, along with CMS and state guidelines. This role ensures that all appeals are set up accurately and in a timely manner, supporting the appeal process efficiently. 

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

  • Receiving and analyzing appeal documentation to determine appropriate actions
  • Accurately setting up and initiating the appeals process timely, ensuring information aligns with provided documents
  • Ensure compliance with HIPAA, CMS guidelines, and client instructions and policy standards
  • Utilize applicable tools and resources to complete setup
  • Additional duties as assigned

KNOWLEDGE & SKILLS:

  • Knowledge of Medicare, Medicaid, and commercial insurance guidelines
  • Strong attention to detail, time management, and organizational skills
  • Excellent written and verbal communication skills
  • Knowledge of medical terminology and CPT/ICD codes
  • Proficiency with Microsoft applications

EDUCATION & EXPERIENCE:

  • High school diploma or equivalent
  • 1+ years of experience in healthcare, insurance, claim processing, or customer service
  • 1+ years working with customers in a fast-paced, deadline-oriented environment
  • 1+ years of experience as an Appeals Representative
  • Strong technical skills with the ability to work across multiple software systems and work remotely with self-management skills

PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location.  Pay rates are established taking into account the following factors:  federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.  Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role.  The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $20.08 - $30.06 per hour

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

ABOUT CERIS: 

CERIS, a division of CorVel Corporation, a certified Great Place to Work® Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). 

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, 

Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401 K, ROTH 401 K, and paid time off. 

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. 

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About CERIS

Sourced by ZipRecruiter

Industry

Health care and social assistance

Company size

51 - 200 Employees

Headquarters location

Fort Worth, TX, US

Year founded

1990

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