Sentara Healthcare
Provider Appeals Coordinator/CPC/CCS- Remote in Virginia or Florida!
This job is now closed
Job Description
- Req#: JR-87716
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Full-time, permanent position with standard working hours from 8 am to 5 pm EST, Monday to Friday
- Opportunity for career advancement and growth within the organization
- Remote work flexibility available in Virginia and Florida
- Comprehensive benefits package including medical, dental, and vision plans
- Tuition assistance of $5,250/year and reimbursement for certifications
- Annual discretionary bonus opportunity based on eligibility criteria
What to Expect (Job Responsibilities):
- Investigate and document member appeals and grievances in compliance with state laws and regulations
- Collaborate closely with the Plan's Medical Directors on clinical appeals and grievances
- Work alongside the Appeals Manager for non-clinical appeals and grievances
- Ensure compliance with provider and group agreements
- Maintain thorough records of investigations and resolutions
What is Required (Qualifications):
- High School Diploma or equivalent required
- Must have Certified Professional Coder (CPC) and Certified Coding Specialist (CCS) certifications from AHIMA
- Minimum of 3 years of experience in managed care required
- Previous provider appeals experience preferred
How to Stand Out (Preferred Qualifications):
- Experience in healthcare-related appeals processes
- Strong analytical and problem-solving skills
- Excellent written and verbal communication skills
- Ability to work independently and as part of a team
- Familiarity with state regulations regarding healthcare appeals
#HealthcareServices #RemoteWork #CareerGrowth #EmployeeBenefits #HealthcareCareersAbout the company
Sentara Healthcare is a not-for-profit healthcare organization serving Virginia and northeastern North Carolina.
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