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Healthcare - Appeals Specialist I
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Full-time
- Dependability, good grammar skills, good phone communication skills, and meet the description in the job chosen (appeals specialist I)
- Research claims appeals and grievances using support systems to determine appeal and grievance outcomes."
- Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and
- Research claims processing guidelines, provider contracts, fee schedules and system configurations to determine root cause of payment error."
- Min. 2 years operational managed care experience (call center, appeals or claims environment)."
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