Hi
We have an urgent role of Appeals Analyst – REMOTE.
URGENT HIRE!
Appeals Analyst – REMOTE
Schedule – Remote – 8am – 4:30pm
Position Type: Contract
Position Length: Unsure, at least through the end of 2026 – def could extend for an entire year !
Target Start Date: ASAP
Required Skills, Knowledge, and Experience:
• Bachelor’s degree in related field. In lieu of degree, five (5) years’ relevant experience will be considered in addition to the experience requirements listed below.
• Minimum three (3) years’ healthcare grievances, appeals, claims processing, claims research, customer service or related legal experience.
• Working knowledge of insurance products, policies, procedures and/or claims processing preferred.
• Experience using Microsoft Office i.e. Word and Excel.
Duties:
The Appeals Analyst reviews and responds to appeals and inquiries from members, providers, authorized representatives, insurance
departments, and/or other regulatory bodies regarding adverse benefit determinations within the timeframes set forth in both federal and
state law. This position must favor neither the Company nor the member and must exercise independent judgment in determining whether
an adverse benefit determination was legal, appropriate, impartial and in accordance with the enterprise’s obligation under the applicable
contract.
Skills:
EXPERIENCE & KNOWLEDGE
Minimum three (3) years’ healthcare grievances, appeals, claims processing, claims research, customer service or related legal experience.
Working knowledge of insurance products, policies, procedures and/or claims processing preferred.
Experience using Microsoft Office i.e. Word and Excel.
ESSENTIAL ABILITIES
Sound Judgement
HIPAA Confidentiality
Legal Confidentiality
Taking Initiative
Location: , ,
LinkedIn: Apply Here