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Appeals Service Representative

Appeals Service Representative

Rose InternationalSan Antonio, TX, US
2 days ago
Job type
  • Full-time
  • Temporary
Job description

Date Posted : 09 / 29 / 2025

Hiring Organization : Rose International

Position Number : 489195

Industry : Pharmaceutical / Healthcare

Job Title : Appeals Service Representative

Job Location : San Antonio, TX, USA, 78238

Work Model : Hybrid

Work Model Details : 3 days a week in the San Antonio office

Employment Type : Temporary

FT / PT : Full-Time

Estimated Duration (In months) : 7

Min Hourly Rate ($) : 17.00

Max Hourly Rate ($) : 17.50

Must Have Skills / Attributes : Customer Service, Data Entry, Insurance, Medical Terminology

Experience Desired : Previous medical insurance background (1 yrs)

Required Minimum Education : High School Diploma or equivalent

Preferred Education : Associate degree

  • C2C is not available

Job Description

Required Education :

  • High School diploma or GED

    • Preferred Qualifications / Skills / Experience :

  • Previous medical insurance background preferred but not required.

    • Appeals Service Representative Overview :

  • The Coverage Determination / Appeals Service Representative I is responsible for working and triaging in the data entry related fax queues.
  • The Representative I’s primary responsibilities will be to review each document with accuracy and place the case in the proper queues.
  • Further responsibilities include researching reports, maintaining complete, timely and accurate documentation of Coverage Determination / Appeal requests and escalating issues to the Coverage Determination / Appeal pharmacists or management staff as needed.
  • Position will require schedule flexibility including rotations through Nights, Weekends and Holiday Coverage.
  • All other duties are required to meet business needs.

    • Job Duties :

  • Review Fax documents appropriately and forward to appropriate queues
  • Update and maintain knowledge of relevant process, regulation and clinical material.
  • Provide assistance or guidance in partnership with learning and innovation when needed
  • Participate in developmental discussions receiving feedback with Supervisor

    • Industry : Healthcare

    Estimated Start Date : 11 / 10 / 2025

  • Only those lawfully authorized to work in the designated country associated with the position will be considered.
  • Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements.

    • Benefits :

    For information and details on employment benefits offered with this position, please visit here. Should you have any questions / concerns, please contact our HR Department via our secure website.

    California Pay Equity :

    For information and details on pay equity laws in California, please visit the State of California Department of Industrial Relations' website here.

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    Service Representative • San Antonio, TX, US