Texas Licensed Appeals Representative

Job Summary

A company is looking for an Appeals Representative III - Team Lead.

Key Responsibilities

• Review and analyze appeal documentation to determine appropriate actions
• Accurately set up and initiate the appeals process in a timely manner
• Ensure compliance with HIPAA, CMS guidelines, and client policy standards

Required Qualifications and Education

• High school diploma or equivalent
• 1+ years of experience in healthcare, insurance, claim processing, or customer service
• 1+ years of experience as an Appeals Representative
• Strong technical skills with the ability to work across multiple software systems
• Experience in a fast-paced, deadline-oriented environment