Appeals Coordinator -
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POST DATE 9/1/2016
END DATE 12/3/2016
JOB DESCRIPTIONDo 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.
? 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