194 appeals jobs at 84 companies in Texas
2mo
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Appeals Professional
Austin or United States
RemoteFull Time
1+ YOEAssociate's degree (or 60+ credits) in healthcare or related, or equivalent experience; 1+ year Medicare appeals/medical review/clinical or healthcare compliance experience; ability to review medical records, make independent decisions, and research regulations.
2mo
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Appeals Professional
Austin or United States
RemoteFull Time
1+ YOEAssociate's degree or 60+ credits in healthcare (or equivalent experience), 1+ year Medicare appeals/medical review/clinical/regulatory experience, US residency 3 of last 5 years, ability to review records and write impartial decisions.
2mo
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Appeals Representative II
Fort Worth, Texas, United States
$20-$30/hr RemoteFull Time
1+ YOEReview and analyze appeal documentation; HIPAA compliance; knowledge of Medicare/Medicaid; 1+ year healthcare/claims or customer service; strong communication; remote work capability.
Microsoft Office
2d
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UMR Appeals Representative
Wausau or Hartford or Minneapolis or Dallas or Phoenix or Tampa or United States
$18-$32/hr RemoteFull Time
1+ YOEHigh school diploma/GED or equivalent experience; 1+ year claims or appeals experience, customer service problem-solving experience, and computer experience with Windows PC applications.
Windows
1w
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Specialist, Appeals & Grievances
Texas, United States
$16-$32/hr OnsiteFull Time
2+ YOERequires 2+ years of managed care, call center, appeals, or claims experience; health claims processing knowledge, Medicaid/Medicare denials and appeals experience, customer service, organization, and communication skills.
Microsoft Office
1mo
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Insurance Appeals Rep
Houston, Texas, United States
OnsiteFull Time
2+ YOEReview clinical documentation and payer guidelines to draft appeals; 2+ years hospital denials experience, Epic HB required, Microsoft Excel, strong research and communication skills.
Epic HB, Microsoft Excel
3w
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M&R Appeals Coder
Atlanta, Texas, United States
$24-$25/hr OnsiteFull Time
Coding certificate (CPC/CCS), strong medical records review skills, experience with Medicare appeals (NCD/LCD, Duplicate, MUE), familiarity with FACETS/COSMOS and CMS guidelines, strong communication and analytical skills.
FACETS, COSMOS
1w
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Appeals Nurse Consultant
Ohio or Mississippi or Texas or North Carolina or Alabama or Florida or South Carolina or Pennsylvania or New Jersey
$61k-$130k/yr RemoteFull Time
3+ YOEActive unrestricted RN license, willingness to obtain a compact RN license within 3 months, 3+ years of Medicare/Medicaid appeals experience, and an associate degree or nursing diploma.
Microsoft Teams, Microsoft Outlook, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Google Workspace, VPN, EHR
2w
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Appeals & Grievances Director
Austin or United States
RemoteFull Time
7+ YOE3+ Mgmt7+ years appeals/grievances or regulatory experience with 3+ years people leadership; Bachelor\u0002s required, Master\u0002s preferred; deep knowledge of CMS/TDI/NCQA/URAC; strong analytics and communication skills.
1mo
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Appeals Specialist - Business Office - Days
Beaumont, Texas, United States
OnsiteFull Time
1+ YOEHigh school diploma, 1-3 years related experience working denied claims and payer appeals, strong billing and communication skills.
1mo
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STAR+PLUS Appeals Nurse RN
Houston, Texas, United States
OnsiteFull Time
1+ YOEActive Texas RN license, 1+ year medical review and acute/managed care experience, experience with prior auth/claims/appeals, strong written/verbal communication.
Microsoft Word, Microsoft Excel, Microsoft Access, Microsoft Outlook
1d
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Appeals Medical Director – Oncology
Chicago or Woodland Hills or Ashburn or Costa Mesa or Hanover or Mason or Wilmington or Cincinnati or Seven Hills or New York City or Grand Prairie or Iselin or Columbus or Durham or Washington or Woburn or Lake Success
$248k-$446k/yr RemoteFull Time
10+ YOERequires MD or DO, applicable ABMS or AOA board certification, active unrestricted medical license, and at least 10 years of clinical experience. Oncology or hematology-oncology certification and appeals experience preferred.
1d
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Appeals and Grievances Intake Lead
Arkansas or Arizona or Florida or Georgia or Iowa or Illinois or Kansas or Kentucky or Michigan or Minnesota or Missouri or North Dakota or Nebraska or Oklahoma or South Dakota or Tennessee or Texas or Virginia or Wisconsin
$57k-$97k/yr RemoteFull Time
4+ YOEHigh school diploma or equivalent and 4+ years of experience as a lead or subject matter expert in appeals and grievances intake or case management.
1w
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Senior Appeals Analyst
Newark or Wisconsin or California or Colorado or Arkansas or Arizona or Alabama or District of Columbia or Florida or Connecticut or Georgia or Delaware or Iowa or Kansas or Indiana or Kentucky or Illinois or Idaho or Louisiana or Massachusetts or Maryland or Maine or North Dakota or Michigan or Mississippi or Washington or Texas or Missouri or Montana or North Carolina or Minnesota or New Hampshire or Oklahoma or Vermont or Nebraska or Tennessee or Nevada or New York or Ohio or Oregon or New Mexico or Pennsylvania or Rhode Island or South Dakota or Utah or South Carolina or West Virginia or Virginia or Wyoming
$67k-$110k/yr RemoteFull Time
3+ YOERequires 3–5 years of short- or long-term disability claims experience, strong analytical and communication skills, knowledge of ERISA and state requirements, and proficiency with claims and Microsoft Office tools.
Microsoft Office
2mo
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Appeals Representative II
Fort Worth, Texas, United States
RemoteFull Time
1+ YOEHigh school diploma; 1+ year experience in healthcare, insurance, claims, or customer service; strong communication and technical skills; remote work capability.
Microsoft Office
1w
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Appeals Registered Nurse
Madison or Colorado or Florida or Georgia or Illinois or Indiana or Iowa or Michigan or Minnesota or Missouri or Nebraska or New Jersey or North Carolina or Ohio or South Carolina or Texas or Virginia or Wisconsin
$66k-$68k/yr RemoteFull Time
1+ YOERequires ASN or BSN, active RN license, 1+ year clinical experience, medical review knowledge, strong communication and organizational skills, and proficiency with Microsoft Office systems.
Microsoft Outlook, Microsoft Teams, Microsoft OneNote, Microsoft Word, Microsoft Excel, Centers for Medicare & Medicaid Services (CMS)
3mo
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Revenue Representative – Appeals and Collection
Houston, Texas, United States
$20/hr OnsiteFull Time
1+ YOE1 year reimbursement experience; High School diploma; strong Excel, ICD-10, CPT knowledge; strong communication and organizational skills.
3d
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Director, Payment Integrity - Appeals & Disputes
Missouri or Georgia or North Carolina or Texas or Illinois or Florida
$118k-$219k/yr RemoteFull Time
7+ YOEBachelor’s degree or equivalent experience and 7+ years in finance, accounting, operations, or auditing; claims operations and compliance experience preferred.
2d
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Care Coordinator - Clinical Appeals RN
United States or Washington or Alaska or Arizona or Arkansas or California or Colorado or Florida or Georgia or Idaho or Iowa or Kansas or Kentucky or Maine or Michigan or Minnesota or Missouri or Montana or Nevada or New Hampshire or New Mexico or North Carolina or Oklahoma or Oregon or South Carolina or South Dakota or Tennessee or Texas or Utah or Wisconsin
$80k-$126k/yr RemoteFull Time
3+ YOECurrent registered nurse license, bachelor's degree or four years' work experience, and three years of clinical experience required; utilization management and health plan experience required or preferred.
Milliman Care Guidelines
1mo
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Medical Billing and Appeals Specialist - Hybrid
Austin or Texas
$20-$25/hr RemoteFull Time
3+ YOEHigh school/GED, 3+ years medical billing/claims experience, Athena and EMR experience, knowledge of CPT/ICD-9/ICD-10, ability to analyze remittance advice, strong communication and attention to detail.
Athena, EMR
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