• Respond to general customer questions via telephone, e-mail, and written correspondence regarding insurance benefits, provider contracts, reimbursement programs, eligibility, and claims in a confidential, professional, and ethical manner. • Analyze problems and provide information/solutions. • Research and resolve aged Customer Service open calls within company standards. • Operate in the Health Care Processing System (HCPS), Imaging systems, and all systems necessary to obtain and extract information with proficiency and skills. • Develop and maintain positive customer relations and coordinate with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner. • Be accountable when you uncover an issue or trend by helping to assess and report its impact, making improvements, and course-correcting along the way. • Follow quality guidelines to provide exceptional customer support and ensure scores meet or exceed expectations. • Accurately document database activity and customer interaction for tracking and analysis to identify trends and address operational and service issues. • Research and analyze data to address standard operational challenges and customer service issues. • Provide customers with requested information, including difficult and upset customers. • Meet or exceed all department and performance service metrics. • Communicate with the appropriate departments and identify service issues. • Identify inefficiencies within the established processes and suggest possible solutions to save time, reduce risk, and/or reduce expenses. • Maintain regular attendance per employee handbook guidelines. • Utilize all capabilities to satisfy one mission — to enhance the competitiveness and profitability of our members.

• Be the first point of contact for German-speaking customers • Handle customer inquiries via phone and email (German) • Process insurance claims and resolve issues efficiently • Escalate complex cases according to internal procedures • Process new vehicle insurance applications • Manage contract changes, conversions, and terminations • Handle correspondence and documentation • Accurate contract logging (business-critical) • Process address changes, account updates, and SEPA mandates • Ensure timely handling of incoming documents (email/post) • Provide insurance advice and prepare tailored offers • Cross-sell additional insurance products (liability, property, legal, etc.) • Support onboarding (e.g., self-service portal registrations) • Schedule pension consultation appointments

• Be the first point of contact for German-speaking customers, handling inbound and outbound communication. • Handle customer inquiries via phone and email (German). • Process insurance claims and resolve issues efficiently. • Escalate complex cases according to internal procedures. • Process new vehicle insurance applications, manage contract changes, conversions, and terminations. • Handle correspondence and documentation with high accuracy required. • Provide insurance advice and prepare tailored offers. • Cross-sell additional insurance products (liability, property, legal, etc.). • Support onboarding (e.g., self-service portal registrations). • Schedule pension consultation appointments.

Role 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. This role ensures that all appeals are set up accurately and in a timely manner, supporting the appeal process efficiently. - 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 Qualifications - Knowledge of Medicare, Medicaid, and commercial insurance guidelines - Strong attention to detail, time management, and organizational skills - Excellent written and verbal communication skills - Knowledge of medical terminology and CPT/ICD codes - Proficiency with Microsoft applications Requirements - High school diploma or equivalent - 1+ years of experience in healthcare, insurance, claim processing, or customer service - 1+ years working with customers in a fast-paced, deadline-oriented environment - 1+ years of experience as an Appeals Representative - Strong technical skills with the ability to work across multiple software systems and work remotely with self-management skills 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 Company Description 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. 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 (ACE-IT!).