Remote Jobs
Appeals Specialist I (Remote)
This job is now closed
Job Description
- Req#: 19352
Employer Industry: Health Insurance Provider
Why Consider this Job Opportunity:
- Salary up to $73,524
- Opportunity for career advancement and growth within the organization
- Work remotely with the flexibility of occasional on-site work
- Collaborative work environment with regular communication and feedback
- Chance to contribute to continuous improvement of unit workflow and processes
- Comprehensive benefits package and incentive programs/plans
What to Expect (Job Responsibilities):
- Prioritize, research, and analyze all pertinent information in preparation of an appeal request
- Utilize professional written and verbal communications to respond to appeals based on State and Federal requirements
- Assist with unit projects and other duties related to the appeals and reconsideration process
- Coordinate file activities, including filing and purging of files for storage
- Participate in meetings and discussions regarding appeal research and data entry
What is Required (Qualifications):
- High School Diploma or GED
- 3 years of experience in managed care, healthcare, or insurance payor environment
- Knowledge and understanding of medical terminology
- Strong problem-solving and decision-making skills
- Excellent organizational and analytical skills
- Ability to meet deadlines and handle multiple customer service demands
How to Stand Out (Preferred Qualifications):
- College Degree
- Knowledge of CareFirst system, Member/Provider Service, Claims, or Care Management experience
#HealthInsuranceProvider #CareerOpportunity #RemoteWork #CollaborativeEnvironment #ComprehensiveBenefits
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.