Appeals Representative Team Lead

5 days ago


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

Job Summary:

The Appeals Representative Team Lead is responsible for overseeing the appeals process for healthcare providers, ensuring compliance with client policy, industry standards, and regulatory guidelines. This role requires strong analytical and communication skills, as well as the ability to interpret complex medical terminology and coding knowledge.

Key Responsibilities:

  • Appeals Process Management: Oversee the appeals process for healthcare providers, ensuring timely and accurate completion of appeals.
  • Client Policy and Regulatory Compliance: Ensure compliance with client policy, industry standards, and regulatory guidelines, including CMS and state guidelines.
  • Communication and Collaboration: Collaborate with internal stakeholders, including clinical and operational teams, to ensure seamless communication and resolution of appeals.
  • Training and Development: Provide training and guidance to team members on appeals process, client policy, and regulatory guidelines.
  • Performance Metrics and Reporting: Track and analyze performance metrics, including appeal resolution rates, timeliness, and quality, to identify areas for improvement.

Requirements:

  • Education: High school diploma or equivalent required.
  • Experience: 3+ years of healthcare revenue cycle experience, including collections, appeals, and denials management.
  • Skills: Excellent written and verbal communication skills, contract interpretation, medical terminology and coding knowledge, proficiency with Microsoft applications.

Benefits:

  • Competitive Salary: $29.63 per hour.
  • Comprehensive Benefits Package: 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.

About CorVel Healthcare Corporation:

CorVel Healthcare Corporation is a leading provider of healthcare risk management solutions, committed to delivering accurate and transparent healthcare payments. We value our employees and offer a stable and growing work environment with opportunities for career advancement.



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