Appeals Service Representative

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.