Appeals Representative III - Team Lead

CorVel
Fort Worth, TX
Category Healthcare
Remote
Job Description
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.

Requirements

  • 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

Benefits

  • 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
  • 401 K
  • ROTH 401 K
  • Paid Time Off
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