Appeals Representative

2 months ago


Fort Worth, United States CornerStone Staffing Full time

We are seeking a detail-oriented and compassionate Appeals Coordinator to join an excellent Healthcare Company in Fort Worth, TX In this role, you will be responsible for reviewing and processing appeals and grievances from patients and providers, ensuring that all cases are resolved promptly and in accordance with regulatory guidelines. The ideal candidate will have a strong background in healthcare administration or insurance, excellent analytical skills, and a passion for helping others.

JOB ID - 147304

Job Title: Appeals Representative

TEMP TO HIRE

Pay: $16/hr - Depending on Experience


Location: Southwest Fort Worth, TX (Clearfork)

  • Will move remote once permanent

Hours: Monday - Friday, 8AM - 5PM

JOB SUMMARY: Responsible for accurately setting up appeals for processing within 24 hours of receipt from various systems and correspondence sources (fax/email/mail). Corresponds with appeal submitters when adequate contact information is not provided upon submission.

DUTIES AND RESPONSIBILITIES:

Ensure documentation received is eligible for appeal

Plan/organize appeals to be entered into the system by department protocol

Enter appeal/claim information proficiently and accurately into appeals system

Attach all appropriate documentation for appeal to the correct case and folder location(s)

Communicate any special handling of each appeal appropriately

Maintains production standards, production requirements, and error rates

Provide support for other co-workers

Complies / maintains HIPAA in all communications and setup functions

Additional duties as assigned

QUALIFICATIONS:

High school diploma or equivalent

1 minute typing with 40 words per minute

Proficient in Microsoft Office suite, mainly Outlook, Excel, WORD

Highly detail oriented with a high rate of accuracy

Ability to perform paperless entry with 3 monitors

Ability to independently use problem solving logics

Exceptional organizational, planning and time management skills

The ability to work independently in a fast paced/production environment

Effectively communicate with others



  • Fort Worth, United States CornerStone Staffing Full time

    We are seeking a detail-oriented and compassionate Appeals Coordinator to join an excellent Healthcare Company in Fort Worth, TX! In this role, you will be responsible for reviewing and processing appeals and grievances from patients and providers, ensuring that all cases are resolved promptly and in accordance with regulatory guidelines. The ideal candidate...


  • Fort Worth, United States CorVel Corporation Full time

    The Appeals Representative is responsible for addressing provider inquiries and appeals via email, fax, telephone, or written correspondence ensuring adherence to client policy, industry standards along with CMS and state guidelines as well as client instructions. This is a onsite position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Reviews, analyzes,...


  • Fort Worth, United States CorVel Corporation Full time

    The Appeals Representative is responsible for addressing provider inquiries and appeals via email, fax, telephone, or written correspondence ensuring adherence to client policy, industry standards along with CMS and state guidelines as well as client instructions. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Reviews, analyzes,...


  • Fort Worth, United States CERIS Health Full time

    The Appeals Representative is responsible for addressing provider inquiries and appeals via email, fax, telephone, or written correspondence ensuring adherence to client policy, industry standards along with CMS and state guidelines as well as client instructions. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES:Reviews, analyzes, and...


  • Fort Worth, Texas, United States CorVel Healthcare Corporation Full time

    Job Title: Appeals Representative Team LeadAt CorVel Healthcare Corporation, we are seeking a highly skilled and experienced Appeals Representative Team Lead to join our team. As a key member of our revenue cycle appeals team, you will be responsible for addressing provider inquiries and appeals in a timely and professional manner.Key Responsibilities:Review...


  • Fort Worth, United States CorVel Corporation Full time

    The Appeals Representative is responsible for addressing provider inquiries and appeals via email, fax, telephone, or written correspondence ensuring adherence to client policy, industry standards along with CMS and state guidelines as well as client instructions. This is remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Reviews, analyzes, and...


  • Fort Worth, TX, United States CornerStone Staffing Full time

    We are seeking a detail-oriented and compassionate Appeals Coordinator to join an excellent Healthcare Company in Fort Worth, TX! In this role, you will be responsible for reviewing and processing appeals and grievances from patients and providers, ensuring that all cases are resolved promptly and in accordance with regulatory guidelines. The ideal candidate...


  • Fort Worth, United States CERIS Health Full time

    The Appeals Representative is responsible for addressing provider inquiries and appeals via email, fax, telephone, or written correspondence ensuring adherence to client policy, industry standards along with CMS and state guidelines as well as client instructions. This is remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES:Reviews, analyzes, and...

  • Sales Representative

    4 weeks ago


    Fort Worth, Texas, United States Puff N Buzz Full time

    Job OverviewPuff N Buzz is seeking a skilled Sales Representative to drive sales and promote our products. As a key member of our team, you will be responsible for resolving customer inquiries, offering solutions, and driving company revenue.Key Responsibilities:Provide exceptional customer service, addressing questions and concerns in a timely and...

  • Sales Representative

    3 weeks ago


    Fort Worth, Texas, United States Puff N Buzz Full time

    Job DescriptionWe are seeking a Sales Representative to drive company revenue by resolving customer questions and offering solutions.Key Responsibilities:Work evenings to engage with customers and promote special offers.Stay informed about products to effectively answer customer questions.Actively promote products and encourage repeat business.Assist in...


  • Fort Worth, Texas, United States Michael's Inc Full time

    Key Responsibilities: Assist customers in finding products and provide a seamless shopping experience Ensure a fast and efficient checkout process Maintain a well-organized and visually appealing store environment Deliver exceptional customer service and resolve any issues that may arise Collaborate with colleagues to achieve store recovery standardsAbout...


  • Fort Worth, Texas, United States Dillard's Full time

    Key Responsibilities: Greet and welcome guests, building relationships and providing exceptional customer service. Discover guests' needs and sell merchandise, meeting and exceeding their expectations. Assist in merchandising through visual placement, ensuring a visually appealing store environment. Reflect the fashion of the store in your look and...


  • Fort Worth, Texas, United States GPM Investments LLC Full time

    Job OverviewWe're seeking a highly motivated and customer-focused individual to join our team as a Cashier/Sales Associate at GPM Investments LLC. As a key member of our retail team, you will be responsible for providing exceptional customer service, maintaining a clean and organized store environment, and achieving sales goals.Key ResponsibilitiesCustomer...


  • Fort Myers, Florida, United States Millennium Physician Group Full time

    Job SummaryWe are seeking a highly skilled Reimbursement Resource Representative Accounts Receivable to join our Medical Billing/Business Services Team at Millennium Physician Group.The ideal candidate will have a strong background in insurance carrier appeals, Athena EMR experience, and excellent communication skills.This is a full-time opportunity with a...

  • Sales Associate

    4 weeks ago


    Fort Worth, Texas, United States James Avery Full time

    Job SummaryWe are seeking a highly motivated and customer-focused Sales Associate to join our team at James Avery. As a Sales Associate, you will be responsible for providing exceptional guest service, selling jewelry, and maintaining a clean and organized store environment.Key ResponsibilitiesProvide excellent guest service, responding to guest inquiries...


  • Fort Worth, Texas, United States Jet Health Full time

    Job OverviewJet Health is seeking a skilled Revenue Cycle Specialist to oversee critical financial tasks, including billing, collections, and claims management. This role requires a strong understanding of state and federal regulations, as well as excellent communication and problem-solving skills.Key ResponsibilitiesMonitor and maintain assigned accounts,...

  • Healthcare Liaison

    4 weeks ago


    Fort Worth, Texas, United States Cook Children's Health Care System Full time

    Job Summary:The Member Advocate will serve as a liaison between the Members and Cook Children's Health Plan. This role requires excellent communication skills to navigate the complexities of the healthcare system and provide a highly satisfactory customer experience. The ideal candidate will have 1-2 years of experience in Community Outreach or Member...


  • Fort Myers, Florida, United States Millennium Physician Group Full time

    Reimbursement Resource Representative OpportunityMillennium Physician Group is seeking a highly skilled and detail-oriented Reimbursement Resource Representative to join our Medical Billing/Business Services Team.About the Role:Responsible for claim resolution and payment, working with insurance carriers and patients to resolve account discrepancies.Utilize...


  • Fort Worth, Texas, United States SUITEMATE STAFFING SOLUTIONS INC Full time

    Job Summary: SUITEMATE STAFFING SOLUTIONS INC is seeking a skilled Community Health Advocate to serve as a liaison between members and the medical plan. The ideal candidate will have excellent communication skills, be bilingual in English and Spanish, and have experience in community outreach or member advocate services.Key Responsibilities:Build rapport...

  • Healthcare Advocate

    4 weeks ago


    Fort Worth, Texas, United States Cook Children's Health Care System Full time

    Job Title: Member AdvocateLocation: Calmont Operations BuildingDepartment: Member AdvocateShift: First Shift (United States of America)Standard Weekly Hours: 40Job Summary:The Member Advocate will serve as a liaison between the members and Cook Children's Health Plan. The Member Advocate will help members and their legally authorized representatives navigate...