Appeals Representative II - Team Lead

$38,189 - $61,630/Yr

CorVel - Fort Worth, TX

Full-time

Fort Worth, TX

Professional, Scientific, and Technical Services

About the position

The Appeals Representative is responsible for managing provider inquiries and appeals through various communication channels, ensuring compliance with client policies, industry standards, and regulatory guidelines. This remote position requires strong analytical skills and the ability to interpret complex information while maintaining professional communication.

Responsibilities

• Review, analyze, and complete appeals in accordance with client policy, CMS guidelines, and industry standards.
• Interpret provider appeals and apply analytical thinking skills.
• Utilize applicable tools and resources to complete appeals.
• Ensure timely completion of appeals.
• Perform additional duties as assigned.

Requirements

• High school diploma or equivalent.
• 3+ years of healthcare revenue cycle experience (collections, appeals, denials management, etc.).
• 2+ years working with customers in a fast-paced, deadline-oriented environment.
• 2+ years experience as an Appeals Representative.
• Prior knowledge of inpatient and outpatient hospital revenue cycle required.
• Excellent written and verbal communication skills.
• Contract interpretation, medical terminology, and coding knowledge.
• Proficiency with Microsoft applications.

Benefits

• Medical (HDHP) with 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
• 401K
• ROTH 401K
• Paid time off