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Responsibilities include contacting the appropriate insurance company to secure and expedite payments through the follow-up and appeals resolution processes, and acting as a functional leader or reference source.
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The ideal candidate would also possess prior experience working in a variety of MA units beyond growth and acquisition (member retention, customer care, care coordination, appeals and grievances, etc.
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May also engage in grievance and appeals reviews. Become a part of our caring community and help us put health first. May also engage in grievance and appeals reviews. Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation.
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The Court of Appeals receives every appeal or judicial review taken from Oregon's trial courts and administrative agencies, with the exception of a limited number of appeals that go directly to the Oregon Supreme Court.
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Three years of experience in nursing, experience with insurance claims/appeals and CPT code knowledge. Evaluate prior authorization requests for medical necessity and review medical records for insurance appeals.
$66,500 - $99,700 a yearFull-timeRemoteExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
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Support healthcare providers with Prior Authorization and Appeals submission to Insurance carrier. Internet requirements include the following:Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location.
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You can make a difference by volunteering in a position that appeals to you and allows you to use your unique skills and talents. The Red Cross offers paid phlebotomy training with the ability to grow your healthcare skills and career within the nation’s top humanitarian organization.
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