Remote Jobs
Appeals and Recovery Support Specialist
This job is now closed
Job Description
- Req#: R105561
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $32.99 per hour
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on client satisfaction and member experience
What to Expect (Job Responsibilities):
- Conduct research and analysis of complex information related to health plan coverage and medical policies
- Assess written and verbal complaints, identifying areas of dissatisfaction and resolving issues
- Educate various departments on appeal and escalation trends, regulatory requirements, and accreditation standards
- Maintain expertise on claims adjudication and benefits for member health plans
- Provide expertise on claims adjudication and benefits for all member health plans
What is Required (Qualifications):
- High school diploma or GED
- Strong computer skills, including proficiency in Excel and Word
- Knowledge of CPT, HCPCS, ICD-9, DRG, and APC coding
- Excellent written and verbal communication skills
How to Stand Out (Preferred Qualifications):
- Some college preferred
- Minimum of five years documented claims processing experience in a managed care environment with two years claims appeals experience
- Working knowledge of Third Party Payor, Medical Group and HMO operations, claims delegation compliance, and contract interpretation
#HealthcareServices #CareerOpportunity #CompetitivePay #BenefitsPackage #EqualOpportunity
We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
The best remote jobs for you
Notice
Talentify is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Talentify provides reasonable accommodations to qualified applicants with disabilities, including disabled veterans. Request assistance at accessibility@talentify.io or 407-000-0000.
Federal law requires every new hire to complete Form I-9 and present proof of identity and U.S. work eligibility.
An Automated Employment Decision Tool (AEDT) will score your job-related skills and responses. Bias-audit & data-use details: www.talentify.io/bias-audit-report. NYC applicants may request an alternative process or accommodation at aedt@talentify.io or 407-000-0000.