This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. 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. This is a remote position. - 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 - Comprehensive benefits package for full-time regular employees includes: - 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!).

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Validation Representative, Motor Vehicle Accident performs all activities involved in the preparation, insurance verification and retrieval of medical records and documents from various systems for the timely filing or re-adjudication of Motor Vehicle Accident claims by the Revenue Specialists. Primarily interacts by phone with outside parties. - Contacting Employers, Insurers and other outside entities via outbound calls, email or fax to verify/obtain information, receipt of Insurance Claim and Bill Review packages related to Motor Vehicle Accident claims. - Manage both inbound and outbound calls efficiently and effectively. - Assist in obtaining supporting claim documentation, appropriately compiling billing packets, and filing insurance claims. - Assist in efficiently moving work through the department, working as part of a team. - Assist with research and support teams within organization as needed. - Use several systems to perform accurate and timely data entry. - File and handle confidential documentation and patient health information (PHI); able to adhere and follow all HIPAA mandated guidelines. - Other duties as required. Qualifications - High School Diploma preferred. - Equivalent combination of education and experience will be considered. - 1 year of medical bill processing experience desired. - Strong phone and verbal communication skills. - Experience with electronic document management in a healthcare setting desired. - Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook). - Regular and predictable attendance. Requirements - Ability to professionally and confidently represent EnableComp to outside parties via phone, email and fax. - Ability to handle large volumes of work while maintaining attention to detail. - Ability to work in a fast-paced environment. - Demonstrated experience in working under limited supervision, manage multiple tasks and prioritize assignments with limited time constraints. - Effectively communicate issues/problems and results that impact timelines for project completion. - Ability to interact professionally at multiple levels within a client-oriented organization. - Competent in MS Office Suite and Windows applications. - General office environment; must be able to sit for long periods of time. Benefits - EnableComp is an Equal Opportunity Employer M/F/D/V. All applicants will be considered for this position based upon experience and knowledge, without regard to race, color, religion, national origin, sexual orientation, ancestry, marital, disabled or veteran status. - We are committed to creating and maintaining a workforce environment that is free from any form of discrimination or harassment. - EnableComp recruits, develops and retains the industry's top talent. - We take pride in our continuous commitment to building and maintaining a culture centered around fostering the professional growth and development of our people. - We believe that investing in our employees is the key to our success.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This role involves leading a customer service team in a remote setting, focusing on flexibility, growth, and meaningful impact. - Customize your schedule and work from home, giving you time for what matters most - Join a nurturing team that values your success and personal well-being - Learn from experienced leaders dedicated to helping you excel in customer service management - Rewarding top performers with unforgettable travel experiences - Comprehensive coverage to protect your well-being - Specialized training programs to sharpen leadership and management skills - Enjoy security, representation, and a supportive community Qualifications - Commitment to delivering exceptional customer service - Strong communication and interpersonal skills - Ability to lead and inspire teams to achieve outstanding results - Desire for professional growth while maintaining a healthy work-life balance Company Description

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This position is ideal for individuals who are motivated by purpose, value helping others, and want to build a long-term career with a company that prioritizes people, ethics, and professional growth. - Support families and children by helping them secure their financial futures, offering peace of mind through reliable protection and guidance. - Enjoy the flexibility and convenience of a fully remote position, allowing you to create a productive work environment that fits your lifestyle. - Guide clients through important financial decisions with clarity, care, and professionalism, ensuring they feel informed and supported every step of the way. - Provide exceptional service grounded in honesty, transparency, and ethical conduct, building long-term relationships based on trust. - Advance within an organization that values your potential and provides clear pathways for career development, leadership opportunities, and ongoing support. Qualifications - A genuine desire to help others and make a positive, lasting impact - Strong communication and interpersonal skills - The ability to work independently while also collaborating effectively as part of a team - A commitment to ethical conduct and professional integrity - Reliability, accountability, and a growth-oriented mindset - No prior industry experience is required—training and mentorship are provided for motivated, coachable individuals. Company Description