Appeals Representative I

2 weeks ago


Fort Worth, United States CorVel Healthcare Corporation Full time
Job DescriptionJob Description

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.

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: $15.98 - $25.69 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



  • Fort Worth, United States CorVel 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. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Reviews, analyzes, and completes appeals in...


  • Fort Worth, United States CorVel 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. ESSENTIAL FUNCTIONS & RESPONSIBILITIES:Reviews, analyzes, and completes appeals in accordance...


  • Fort Lauderdale, United States Nova Southeastern University Full time

    **Patient Account Representative I - 993870**: **Job Number**: 505754 **Work Type**: Full Time with Full Benefits **Location**: Fort Lauderdale-Davie, Florida **Department**: Davie Med Clinic MA Pool **Categories**: Healthcare - Clinic Administration, Medical Professionals & Technicians **About Us**: **We are excited that you are considering joining...


  • Fort Worth, United States CorVel Full time

    ** Insurance Customer Service Representative** **Job Category****:** Administrative (Field) **Requisition Number****:** INSUR004823 Showing 1 location **Job Details** **Description** CorVel in Fort Worth, TX is seeking a full time Insurance Customer Service Representative. The Insurance Customer Service Representative is responsible for addressing client...


  • Fort Worth, Texas, United States Canon U.S.A., Inc. Full time

    Office Service Representative IJob LocationsUS-TX-FORT WORTHRequisition ID # of Openings1Category (Portal Searching)Customer Service/SupportPosition Type (Portal Searching)Regular Full-TimeOverviewUnder general supervision, is responsible for all mail, packages and interoffice correspondence handling and dispatching for all classes of mail/packages....


  • Fort Worth, United States JPS Health Network Full time

    The Patient Exp Interpreter I acts as the primary representative of the Patient Experience Team and serves as a liaison between patients, family members, visitors and clinical staff, and works to identify concerns to facilitate improvement in the ove Interpreter, Patient, Experience, Healthcare, Nurse Manager, Medical


  • Fort Worth, United States KITE'S CLEANERS, INC. Full time

    We are seeking the right individual to work with 2 to 4 others with a common goal of creating and maintaining client relationships with outstanding customer service. Major Responsibilities * Maintain the call office to the standards set by company. * Provide accurate and courteous service to the customer. * Count garments, invoice, inspect for stains or...


  • Fort Worth, United States CornerStone Staffing Full time

    CornerStone Staffing has partnered with a MAJOR HEALTHCARE NETWORK in Fort Worth and is currently recruiting for the following position: Job Title: Patient Account Representative Location: Downtown Fort Worth Pay: $18/hr or more (Depending on Experience) Schedule: 8:30am – 5:30pm, Monday-Friday Duration: Possible Temp to Hire Job Description: The...


  • Fort Worth, United States Acara Solutions, An Aleron Company Full time

    Acara solutions is looking for a Builder Support Representative to hire in Fort Worth, TX for our partnerPay Rate: $22 - $24/hrThe primary responsibility of the Builder Support Representative Level I role is to assist the Outside Builder Sales team in the sales cycle, adding value to create customers for life. This includes problem solving, tracking orders,...


  • Fort Worth, United States CornerStone Staffing Full time

    CornerStone Staffing has partnered with a MAJOR HEALTHCARE NETWORK in Fort Worth and is currently recruiting for the following position: Job Title: Patient Account Representative Location: Downtown Fort Worth Pay: $18/hr or more (Depending on Experience) Schedule: 8:30am – 5:30pm, Monday-Friday Duration: Possible Temp to Hire Job Description: The...


  • Fort Worth, United States Benbrook Water Authority Full time

    Job DescriptionJob DescriptionDEPARTMENT: Administration SALARY GRADE: 5SUMMARY: Under basic supervision, performs customer service functions for clients of the Benbrook Water Authority (BWA).ESSENTIAL FUNCTIONS: The following duties ARE NOT intended to serve as a comprehensive list of all duties performed by all employees in this classification, only a...


  • Fort Worth, United States Deluxe Full time

    Responsible for effectively answering inbound calls from our credit card merchants and sales representatives, and resolving issues in order to ensure customer satisfaction.• Process inbound calls to the point of resolution including customer inquiries, complaints, requests for technical support, and customer account information.• Provide frontline...


  • Fort Worth, United States Ethos Veterinary Health Full time

    Are you looking to be a part of an amazing team of people who get to help provide state-of-the-art healthcare to our companion animals? Dallas Veterinary Surgical Center – Fort Worth Location- is currently seeking a qualified, driven individual to deliver excellent client and patient care as one of our extremely valued client service...


  • Fort Worth, United States State Farm Insurance Agency Full time

    Job DescriptionJob Description We are an award winning State Farm agency focused on fulfilling the needs of our customers and creating success for our team. My Unique Ability is empowering others to achieve their potential and strategizing simple solutions that build confidence in our shared future. If you have experience in the insurance industry, I invite...


  • Fort Worth, United States Simmons Bank Full time

    It's fun to work in a company where people truly BELIEVE in what they're doing!We're committed to bringing passion and customer focus to the business.The Bank Operations Specialist I, as a member of the Operation's Team that supports the processing for all bank's transaction channels, is responsible for performing a wide variety of bank operational duties in...


  • Fort Lee, United States 61st Street Service Corp Full time

    Career Opportunities with 61st Street Service Corp Current job opportunities are posted here as they become available. Account Receivable Specialist I #Full Time The Accounts Receivable Specialist I is responsible for follow-up work to collect on all open and unpaid accounts with insurance companies and third parties. Responsibilities include inquiring about...

  • Handler I, Material

    6 days ago


    Fort Worth, United States LC Industries Full time

    LC Industries - Job DescriptionMaterial Handler II. JOB DESCRIPTION Department: Distribution Location: Durham, NC / Las Vegas, NV / Ft. Worth, TX Reports to: Supervisor, Distribution II. STATEMENT OF PURPOSE To perform assigned duties that supports the warehouse goals. III. RESPONSIBILITY FOR WORK OF OTHERS None. IV. BUSINESS COMMUNICATION Must be able to...


  • Fort Lee, United States 61st Street Service Corp Full time

    **Job Summary**: The Accounts Receivable Specialist I is responsible for follow-up work to collect on all open and unpaid accounts with insurance companies and third parties. Responsibilities include inquiring about unpaid claims, appealing denied claims with insurance companies, and contacting patients or account guarantor. The Accounts Receivable...


  • Fort Worth, United States Tactical Air Support Full time

    Job DescriptionJob DescriptionTactical Air Support Inc.Quality Assurance Representative Fort Worth, TexasSalary rate: $32.00 - $37.00 hourly, DOEPosition SummaryTactical Air is currently seeking a Quality Assurance (QA) Representative for our Fort Worth location. Under general supervision, the QA Representative will monitor and evaluate all processes and...


  • Fort Worth, United States Tactical Air Support Full time

    Tactical Air Support Inc. Quality Assurance RepresentativeFort Worth, TexasSalary rate: $32.00 - $37.00 hourly, DOEPosition SummaryTactical Air is currently seeking a Quality Assurance (QA) Representative for our Fort Worth location. Under general supervision, the QA Representative will monitor and evaluate all processes and procedures of the shipping and...