CareFirst BlueCross BlueShield
Appeals Specialist I (Remote)
This job is now closed
Job Description
- Req#: 13902228
Employer Industry: Medical Management
Why Consider this Job Opportunity:
- Competitive salary up to [highest pay]
- Bonuses based on performance
- Comprehensive benefits package including health insurance, retirement plans, and paid time off
- Opportunities for career advancement and growth within the organization
- Flexibility to work remotely
- Collaborative and supportive work environment
What to Expect (Job Responsibilities):
- Assist with medical management functions such as utilization management, case management, and disease management
- Conduct medical reviews and assessments to determine appropriate care and treatment plans
- Collaborate with healthcare providers to ensure quality and cost-effective care
- Monitor and evaluate the effectiveness of care plans and make recommendations for improvement
- Maintain accurate and up-to-date documentation of all medical management activities
What is Required (Qualifications):
- Bachelor's degree in a healthcare-related field
- Minimum of 2 years of experience in medical management or a related role
- Knowledge of healthcare regulations and industry standards
- Strong analytical and problem-solving skills
- Excellent communication and interpersonal skills
How to Stand Out (Preferred Qualifications):
- Certified Case Manager (CCM) credential
- Experience with electronic health record systems
- Knowledge of medical coding and billing processes
- Familiarity with healthcare quality improvement initiatives
- Bilingual in English and Spanish
#MedicalManagement #HealthcareIndustry #CareerOpportunity #CompetitivePay #RemoteWork
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