Appeals Representative II
CERISFort Worth, Texas, United States • United States
Posted July 31, 2025
37600 - 60680 USD year
Full Time
About the Company
CERiS, a division of CorVel Corporation, a certified Great Place to Work Company, offers incremental value, experience, and a sincere dedication to our valued partners.
Job Description
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.
Requirements
- 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
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
- 401K
- ROTH 401K
- Paid Time Off