Resume

Appeals Specialist Resume Example & Writing Guide

Use this Appeals Specialist resume example and guide to improve your career and write a powerful resume that will separate you from the competition.

Appeals specialists are responsible for handling customer complaints or requests for refunds or price adjustments. They’re also in charge of handling returns and exchanges.

Because they work with customers directly, appeals specialists need strong interpersonal skills. They need to be patient and friendly while also being firm and confident. And they need to be comfortable fielding questions and concerns that might make other people feel uncomfortable.

Here are some tips and an example to help you write an effective appeals specialist resume that hiring managers will love.

Mary Thompson
Houston, TX | (123) 456-7891 | [email protected]
Summary

Experienced legal professional with over 10 years of experience in the legal field and a record of success in managing and winning appeals. Skilled in legal research and writing, critical thinking, and client communication. Passionate about helping those in need and ensuring that all have access to justice.

Education
University of Texas at Austin Jun '10
B.A. in English
Experience
Company A, Appeals Specialist Jan '17 – Current
  • Managed the appeals process for all products and services, including reviewing documentation to determine if an appeal is warranted.
  • Provided customers with timely decisions on their appeals within established timeframes and escalated cases as needed to ensure a fair resolution in a timely manner.
  • Assisted customers with account inquiries related to their pending appeal(s).
  • Maintained knowledge of applicable laws, regulations, policies, procedures, etc., pertaining to assigned duties/responsibilities.
  • Performed other job-related duties as assigned by management or consistent with position description when required due to absence or unavailability of supervisor or co-worker.
Company B, Appeals Specialist Jan '12 – Dec '16
  • Created and maintained a database of all appeals, which included information on the status of each appeal
  • Prepared letters to customers regarding their denied appeals, ensuring that they understood the reasons for denial
  • Answered customer calls about their denied appeals, providing them with additional information when necessary
  • Maintained an accurate record of all appealed claims by logging details in Excel spreadsheets
  • Collaborated with management to create new procedures for tracking and resolving appeals efficiently
Company C, Customer Service Representative Jan '09 – Dec '11
  • Provided phone and email support to customers regarding account information, billing inquiries, service issues, promotions and sales; assisted with social media channels including Facebook Messenger, Twitter DM and Snap Chat posts.
  • Handled incoming telephone calls from current as well as prospective customers in a prompt, professional manner while effectively communicating the company’s value proposition.
  • Set up appointments for technicians to perform installations or repairs at customer homes or businesses using Salesforce appointment scheduling software.
Certifications
  • Certified Appeals Specialist
  • Certified Medicare Secondary Payer (MSP) Professional
  • Certified Healthcare Compliance Professional (CHC)
Skills

Industry Knowledge: Medical Terminology, HIPAA, Medical Law, Medical Ethics
Technical Skills: Microsoft Office Suite, Microsoft Excel, Microsoft PowerPoint
Soft Skills: Communication, Critical Thinking, Decision-Making, Problem Solving, Teamwork, Leadership

How to Write an Appeals Specialist Resume

Here’s how to write an resume of your own.

Write Compelling Bullet Points

The best way to make your resume stand out is to use specific examples and numbers. So rather than saying you “managed appeals process,” you could say that you “managed appeals process for 300+ employees, reducing average appeal time from 6 weeks to 2 weeks, resulting in $1.2 million in annual savings.”

The second bullet point is much stronger because it provides specific details about what you did, how many people you did it for, and the results of your work.

Identify and Include Relevant Keywords

When you submit your resume online, it’s likely that it will be scanned by an applicant tracking system (ATS) for certain keywords. These programs search for specific terms that are relevant to the job opening. If your resume doesn’t include enough of the right terms, the ATS might not forward your application to a recruiter.

One way to make sure your resume makes it past the ATS is to include relevant keywords throughout all sections of your resume. You can find some of the most commonly used keywords for appeals specialist roles below:

  • Legal Advice
  • Legal Research
  • Litigation
  • Legal Writing
  • Appeals
  • Trial Practice
  • Hearings
  • Civil Litigation
  • Mediation
  • Commercial Litigation
  • Administrative Law
  • Family Law
  • Corporate Law
  • Legal Compliance
  • Arbitration
  • Personal Injury Law
  • Westlaw
  • Litigation Management
  • LexisNexis
  • Pleadings
  • Document Drafting
  • Document Review
  • Intellectual Property
  • Westlaw Practice Advantage
  • Trials
  • Corporate Governance
  • Consumer Law
  • Legal Issues
  • Labor and Employment Law
  • Appeals Process

Showcase Your Technical Skills

As an appeals specialist, you will need to have excellent research skills in order to find the relevant information needed to support your client’s appeal. You will also need to be proficient in the use of technology, as you will be using a variety of software programs to manage your work.

Some of the programs and systems that appeals specialists are typically expected to be proficient in include: case management software, legal research databases, and document management systems. Additionally, appeals specialists need to have strong writing and communication skills in order to effectively present their findings.

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