03/03/2026
The Appeals Representative is responsible for reviewing, analyzing, and addressing provider inquiries and appeals via email, fax, telephone, or written correspondence in accordance with regulatory guidelines, client policy and instructions, and industry standards, along with CMS and state guidelines. This role ensures that all appeals are set up accurately and in a timely manner, supporting the appeal process efficiently.
This is a remote position.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
Receiving and analyzing appeal documentation to determine appropriate actions
Accurately setting up and initiating the appeals process timely, ensuring information aligns with provided documents
Ensure compliance with HIPAA, CMS guidelines, and client instructions and policy standards
Utilize applicable tools and resources to complete setup
Additional duties as assigned
KNOWLEDGE & SKILLS:
Knowledge of Medicare, Medicaid, and commercial insurance guidelines...
CorVel
Fort Worth, TX, USA
Full Time
