Appeals Representative II

Overview

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 role.

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

Qualifications

Education & Experience

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 : $18.80 - $30.34 per hour

Benefits

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

Equal Opportunity

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

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