Appeals Representative (Remote)

Job Description

Job Description

Job Title: Appeals Representative

Location (City, State): Remote

Industry: Healthcare | Revenue Cycle Management | Insurance

Pay: $17.00 / hour + Monthly Performance Bonus (up to $200)

Benefits: This role is eligible for medical, dental, vision and 401k.

About Our Client:

Addison Group is partnering with a growing healthcare organization that specializes in revenue cycle support. Our client is seeking detail-oriented Appeals Representatives to join their remote team and assist with reviewing, processing, and resolving healthcare appeals while ensuring compliance with industry and regulatory standards.

Job Description:

Our client is looking for motivated professionals with healthcare or insurance experience to support the appeals process from intake through setup. This position is ideal for individuals who enjoy investigative work, have strong attention to detail, and are comfortable working independently in a fast-paced remote environment.

Key Responsibilities:

• Review and evaluate provider appeals and supporting documentation received through multiple communication channels.
• Accurately initiate and document appeals within internal systems while meeting established turnaround times.
• Analyze claim information and determine appropriate next steps based on client guidelines and regulatory requirements.
• Research healthcare claims and supporting documentation to ensure accurate appeal processing.
• Maintain compliance with HIPAA, CMS regulations, and client policies.
• Utilize multiple systems and software applications to manage workloads efficiently.
• Communicate professionally with providers and internal teams regarding appeal status and required documentation.
• Ensure all records are complete, accurate, and properly documented throughout the appeals process.

Qualifications:

• At least 1 year of experience in healthcare, medical claims, insurance, revenue cycle, or a related customer service environment.
• Previous experience handling medical appeals is strongly preferred.
• Familiarity with medical insurance, explanation of benefits (EOBs), and healthcare claims processing.
• Knowledge of Medicare, Medicaid, and commercial insurance guidelines is preferred.
• Understanding of medical terminology, CPT codes, and ICD coding.
• Strong data entry, organizational, and time management skills with exceptional attention to detail.
• Proficiency with Microsoft Office and the ability to navigate multiple software applications simultaneously.
• Excellent written and verbal communication skills.
• Ability to work independently in a remote environment while consistently meeting productivity and quality goals.

Additional Details:

• Number of Openings: 2
• Employment Type: Direct Hire
• Work Setting: 100% Remote
• Schedule: Monday-Friday, 8:00 AM-5:00 PM
• Internet Stipend: $40/month reimbursement
• Performance Incentive: Eligible for a monthly bonus of up to $200 based on performance metrics.
• Interview Process: One virtual interview with the hiring manager.
• Start Date: ASAP

Perks:

• Fully remote opportunity
• Monthly performance bonus opportunity
• Internet reimbursement provided
• Direct Hire position with long-term career growth potential
• Collaborative and supportive team environment
• Opportunity to build experience within healthcare revenue cycle operations

Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.

#HC1