September 01, 2016

Appeals Coordinator -

AppleOne - Phoenix, AZ

View Job Summary View Job Summary
  • Company
    AppleOne AppleOne
  • Location
    Phoenix, AZ
  • Job Type
  • Job Classification
    Full Time
  • Salary Range
    ≤ $17.00 per hour
  • Company Ref #
  • AJE Ref #
  • Number of Positions
  • Required Licenses/Certificates

Job Description

Do you have a passion for appeals? You will be providing expertise in reviewing, researching including investigating, negotiating, and resolving all types of appeals and grievances, both verbal & written, from members and providers within stringent timeframes
Essential Duties and Responsibilities:
? Prepare acknowledgment and response letters to members and providers
? Maintain case records on all complaints, grievances, and appeals
? Identify, research and resolve claim disputes received from a variety of sources
? Understanding of claims processing and an ability to research claims issues
? Ability to multitask on multiple appeals simultaneously, prioritizing work and completing within stringent timeframes
? Prepare statistical analysis for required reporting
? Analyzes and tracks trends
? Other duties as assigned
Apply with Cheryl today. We are an equal employment opportunity employer and will consider all qualified candidates without regard to disability or protected veteran status.

Job Experience:

? Prior grievance and appeals experience preferred
? Minimum five years claims experience with coding certificate or,
? Certified professional coder with experience handling appeal in a providers office
? Proficiency in interpretation