Current jobs related to Appeals Representative Team Lead - Texas - CorVel Corporation

  • Appeals Representative Team Lead

    1 month ago

    Texas, 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...

  • Clinical Appeals Registered Nurse

    2 days ago

    Huntsville, Texas, United States Huntsville Memorial Hospital Full time

    Position Overview:Under the guidance of the Director of Case Management, the Clinical Appeals Registered Nurse is responsible for reviewing and contesting medical service denials that may have occurred during the initial claims assessment phase. Denials may arise from inadequate medical documentation, billing discrepancies, utilization assessments, or...

  • Procurement Team Lead

    3 weeks ago

    Texas, United States CorVel Corporation Full time

    Procurement Team Lead Job DescriptionThe Procurement Team Lead position is responsible for overseeing a team to ensure protocol compliance and efficient claim processing. This role involves both hands-on production work and providing support to the direct supervisor when needed.Essential Functions & Responsibilities:Monitor and report Aging Reports for...

  • Claims Recovery Operations Team Supervisor

    7 days ago

    Texas, United States Gainwell Technologies LLC Full time

    About Gainwell Technologies LLCAt Gainwell Technologies, we recognize that exceptional companies are built by exceptional teams. Our organization is dedicated to addressing business challenges and enhancing operational efficiency. We offer a rewarding environment where you can advance your career while enjoying flexibility, continuous learning, and...

  • Procurement Team Lead

    3 months ago

    Texas, United States CorVel Corporation Full time

    The Procurement Team Lead position is 50% production and 50% assisting and supporting direct supervisor with ensuring their team meets protocol, as well as, performing supervisor duties if and when the supervisor is out. This is an in-office role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Monitor/Audit and report Both Aging Reports for Procurement and...

  • Lead Specialist in Medical Claims Operations

    2 days ago

    Texas, United States Gainwell Technologies LLC Full time

    OverviewIn the realm of healthcare, exceptional teams are essential for driving operational success. At Gainwell Technologies LLC, we recognize the value of our workforce and the importance of fostering an environment that encourages professional growth, flexibility, and continuous learning.Position SummaryWe are in search of a proactive and skilled Medical...

  • Lead Specialist in Medical Claims Operations

    7 days ago

    Texas, United States Gainwell Technologies LLC Full time

    OverviewSuccessful organizations rely on effective teams to enhance their operational efficiency. At Gainwell Technologies LLC, we offer a unique opportunity to advance your career in an environment that values your input and emphasizes flexibility, continuous learning, and professional growth.Position SummaryWe are in search of a proactive and knowledgeable...

  • Lead .NET Engineer

    2 days ago

    Texas, United States Austin Fraser Full time

    Austin Fraser is collaborating with a distinguished client in their quest for a Senior .NET Software Engineer. This position presents an excellent opportunity for a seasoned Developer or a Mid-Level Developer looking to elevate their career through innovative development projects for a commendable organization. The software solutions provided by this company...

  • Lead .NET Engineer

    2 days ago

    Texas, United States Austin Fraser Full time

    Austin Fraser is collaborating with a valued client in their quest for a Senior .NET Software Developer. This role presents an excellent opportunity for a seasoned Developer or a Mid-Level Developer eager to advance their career through innovative development for a commendable organization. The software produced by this company contributes positively to...

  • Lead .NET Engineer

    6 days ago

    Texas, United States Austin Fraser Full time

    Austin Fraser is collaborating with a distinguished client in their quest for a Senior .NET Software Engineer. This position offers an excellent chance for a seasoned Developer or a Mid-Level Developer aspiring to elevate their career through innovative development for a commendable organization. The software produced by this company contributes positively...

  • Correspondence Team Lead

    2 months ago

    Texas, United States CorVel Corporation Full time

    Responsible for monitoring and tracking all processes. Run quires and maintain reports. Train new employees and keep up with the correspondence training material. Assist the supervisor with additional projects/task. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Create & maintain reports in worksheets and formulas in Excel Running...

  • Application Support Team Lead

    7 days ago

    San Antonio, Texas, United States Peraton Full time

    Key Responsibilities:The Application Support Team Lead is tasked with ensuring that the Tier 1 Application Support personnel are equipped to address and resolve any technical issues or requests related to supported MHS Applications, encompassing both proprietary and vendor-supplied software and hardware. This Lead role is pivotal in keeping the Application...

  • Field Service Team Lead

    1 month ago

    Texas City, United States ShiftCode Analytics Full time

    All visa except H1b, cpt, opt interivew- phone and video call **ONLY CANDIDATES LOCAL TO MESQUITE, TX NEED APPLY** **Position is 100% onsite in Mesquite, TX** client in Mesquite, Texas. The worker will have experience in a Team Lead, Manager, or Leadership position. Performs planning, organizing,staffing, leading, and disciplinary actions. Serves as an...

  • Team Lead Collections Strategy and Operations

    3 days ago

    San Antonio, Texas, United States PenFed Credit Union Full time

    Job SummaryWe are seeking a highly skilled Team Lead Collections Strategy and Operations to join our team at PenFed Credit Union. This role offers a unique opportunity to thrive in a dynamic team environment, working to ensure world-class service to members, employees, and communities.About the RoleThe Team Lead Collections Strategy and Operations will be...

  • Lead Creative Writer

    7 days ago

    Austin, Texas, United States Bakery Agency Full time

    Position Overview:We are on the lookout for a skilled Lead Creative Writer. In collaboration with fellow creatives, our writers play a pivotal role in generating innovative ideas that align with our strategic goals. If you possess the ability to work alongside diverse creative talents, craft original concepts across various platforms, and present them in...

  • Senior RBT Team Lead

    4 days ago

    Keller, Texas, United States Behavioral Innovations Full time

    Job SummaryWe are seeking a highly skilled and experienced Registered Behavior Technician (RBT) to join our team as a Senior RBT Team Lead at Behavioral Innovations. This role will provide support to our Therapists/RBTs and clients by filling in for missing team members, limiting non-billable hours due to grouping or credentialing.Key ResponsibilitiesConduct...

  • Engineering Team Lead

    2 days ago

    East Texas, PA, United States WINTER INTERNATIONAL LLC - EO Full time

    We are Winter International LLC —a comprehensive ecosystem designed for the growth of your entire team. Our ecosystem encompasses essential tools for strategic planning, defining roles, and a platform for both Leadership and Departmental teams to conduct impactful weekly meetings. This position is fully remote, reflecting our commitment to a flexible...

  • Lead Wind Energy Technician

    7 days ago

    Texas, United States NextEra Energy, Inc. Full time

    Position OverviewAs a Lead Wind Energy Technician on the Renewable Central Maintenance Team, you will play a pivotal role in ensuring the safe and efficient operation of wind farm facilities. Your primary responsibility will be to execute field-based troubleshooting and diagnostics, focusing on long-term reliability and financial performance.Key...

  • Engineering Team Lead

    2 days ago

    San Antonio, Texas, United States H-E-B Full time

    Key Responsibilities:H-E-B Digital is on the lookout for dedicated team members (Partners)Since our establishment, we have been significantly investing in enhancing our customers' digital journey, transforming how they discover culinary inspiration, make food choices, and ultimately bring food into their homes. This is an exhilarating moment to join H-E-B...

  • Medical Sales Representative

    7 days ago

    Texas, United States Culver Careers (CulverCareers) Full time

    Position Overview:Location: North Houston areaAre you eager to make a difference in the thriving medical sector?Do you have a strong commitment to health and wellness?Culver Careers is representing a prominent healthcare organization seeking to onboard individuals with 1-5 years of experience in outside sales across various products or services.We are...

Appeals Representative Team Lead

1 month ago

Texas, 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 completes appeals in accordance with client policy, CMS guidelines and industry standards in clear and professional written communication
  • Ability to appropriately interpret provider appeals and apply analytical thinking skills
  • Ability to interpret client policy and CMS guidelines as it relates to reviews done by CERiS such as itemized bill
  • Utilize applicable tools and resources to complete appeals
  • Timely completion of appeals
  • Additional duties as assigned

KNOWLEDGE & SKILLS:

  • 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

EDUCATION & EXPERIENCE:

  • 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
  • Strong attention to detail, organizational and time management skills with the ability to
  • interpret, research and identify core issues
  • Strong customer focus, analytical and decision making skills
  • Strong technical skills with the ability to work across multiple software systems and comfortable work remote out of your home

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: $ $29.63 per hour

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

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, 401K, ROTH 401K, and paid time off.

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

#LI-Remote