Remote Appeals Specialist II

CorVel Corporation; Fort Worth, Northern (TX, KY); Hybrid; USD 40,000 - 60,000; Full time

Benefits offered by this job

Medical (HDHP) w/Pharmacy

Dental

Vision

401 K

ROTH 401 K

Paid time off

Job summary

CorVel Corporation, via its CERIS division, is seeking an Appeals Representative to review and address provider inquiries and appeals by email, fax, telephone, or written correspondence in accordance with regulatory guidelines, client policy and instructions, and industry standards. The role ensures all appeals are set up accurately and timely to support the appeal process efficiently.

The incumbent will handle receiving and analyzing appeal documentation, ensure timely setup, and maintain HIPAA

Qualifications

• Knowledge of Medicare, Medicaid, and commercial insurance guidelines.
• Strong attention to detail, time management, and organizational skills.
• Excellent written and verbal communication skills.
• Knowledge of medical terminology and CPT/ICD codes.
• Proficiency with multiple software systems and remote work capability.

Responsibilities

• Receiving and analyzing appeal documentation to determine appropriate actions
• Accurately setting up and initiating the appeals process timely
• Ensure compliance with HIPAA, CMS guidelines, and client instructions and policy standards
• Utilize applicable tools and resources to complete setup
• Additional duties as assigned

Skills

Medicare guidelines

HIPAA compliance

Attention to detail

Communication skills

CPT/ICD knowledge

Microsoft Office

Education

High school diploma or equivalent

Tools

Microsoft applications

Job description

CorVel Corporation, via its CERIS division, is seeking an Appeals Representative to review and address provider inquiries and appeals by email, fax, telephone, or written correspondence in accordance with regulatory guidelines, client policy and instructions, and industry standards. The role ensures all appeals are set up accurately and timely to support the appeal process efficiently.

The incumbent will handle receiving and analyzing appeal documentation, ensure timely setup, and maintain HIPAA