CERIS
Overview
The Appeals Representative II at CERIS addresses provider inquiries and appeals via email, fax, telephone, or written correspondence, ensuring adherence to client policy, industry standards, CMS and state guidelines, as well as client instructions. This is a remote role. Responsibilities
Review, analyze, and complete appeals in accordance with client policy, CMS guidelines and industry standards in clear and professional written communication Interpret provider appeals and apply analytical thinking skills as appropriate Interpret client policy and CMS guidelines as it relates to CERIS reviews such as itemized bills Utilize applicable tools and resources to complete appeals Timely completion of appeals Additional duties as assigned Knowledge & Skills
Prior knowledge of inpatient and outpatient hospital revenue cycle required Excellent written and verbal communication skills Contract interpretation, medical terminology and coding knowledge Proficiency with Microsoft applications Education & Experience
High school diploma or equivalent 3+ years of healthcare revenue cycle experience (collections, appeals, denials management, etc) 2+ years working with customers in a fast-paced, deadline-oriented environment 2+ years experience as an Appeals Representative Strong attention to detail, organizational and time management skills with the ability to interpret, research and identify core issues Strong customer focus, analytical and decision making skills Strong technical skills with the ability to work across multiple software systems and comfortable work remote out of your home 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. In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. About CERIS
CERIS, a division of CorVel Corporation, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
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The Appeals Representative II at CERIS addresses provider inquiries and appeals via email, fax, telephone, or written correspondence, ensuring adherence to client policy, industry standards, CMS and state guidelines, as well as client instructions. This is a remote role. Responsibilities
Review, analyze, and complete appeals in accordance with client policy, CMS guidelines and industry standards in clear and professional written communication Interpret provider appeals and apply analytical thinking skills as appropriate Interpret client policy and CMS guidelines as it relates to CERIS reviews such as itemized bills Utilize applicable tools and resources to complete appeals Timely completion of appeals Additional duties as assigned Knowledge & Skills
Prior knowledge of inpatient and outpatient hospital revenue cycle required Excellent written and verbal communication skills Contract interpretation, medical terminology and coding knowledge Proficiency with Microsoft applications Education & Experience
High school diploma or equivalent 3+ years of healthcare revenue cycle experience (collections, appeals, denials management, etc) 2+ years working with customers in a fast-paced, deadline-oriented environment 2+ years experience as an Appeals Representative Strong attention to detail, organizational and time management skills with the ability to interpret, research and identify core issues Strong customer focus, analytical and decision making skills Strong technical skills with the ability to work across multiple software systems and comfortable work remote out of your home 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. In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. About CERIS
CERIS, a division of CorVel Corporation, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
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