Remote - Appeals Coordinator (WA - Remote)

Job Title: Appeal Coordinator

Contract Duration: 9+ months

Pay Rate: $22-24 (based on experience)

Location: Remote - PST time

Work Hours: 11:00- 8:00pm EST

Qualifications/Skills Needed

Required Skills/Experience:

Preferred Skills/ Experience

Need to have some sort of medical office, billing, coding, etc.

TruCare, Peer to Peer, Appeals

CPT, ICD-10 codes are required to know

Call Center Experience (healthcare) Medicaid / Marketplace experience is a bonus.

Education Requirement

High School Diploma

Education Preferred

High School Diploma

Need to have a background working within the medical field.
Need to have a high-level knowledge of appeals.
CPT, ICD-10 codes are required to know
Ability to work in highly productive environment
Team is ever evolving; this person must be able to go with the flow and adapt

Day To Day Responsibilities Of Role

Reviewing denial requests to see if they require a clinical review or medical criteria.
Using multiple systems to review appeals
Taking calls for peer to peer based on denial letter that are generated.
On average this person would be handling inbound / outbound calling (10-20 calls approximately per day)

Performance Expectations

Quality and Quantitively with Productivity.
Would be given a goal and would be expected to meet after training takes place.
This person must be able to send out Microsoft Calendar Invite.

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