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Job Description: Appeals Coordinator (Hybrid Position)
Our client, a leading company specializing in non-invasive skin cancer treatment, is seeking an experienced and detail-oriented Appeals Coordinator to join their team. This is a hybrid position, allowing you to work from home two days per week and spend the other three days in our Burr Ridge office. As an Appeals Coordinator, you will play a crucial role in investigating and resolving complex patient and insurance provider complaints related to enrollment and claims, medical appeals, and provider payment disputes within the healthcare industry.
Responsibilities:
Appeals Investigation: Investigate and resolve patient and insurance provider complaints, conducting in-depth reviews of clinical information and nationally recognized criteria to determine the need for requested services.
Case Review: Prepare detailed reviews of cases that do not meet the criteria for requested services, ensuring accurate and comprehensive documentation.
Data Analysis and Reporting: Gather, analyze, and report all information related to appeals, providing clear and concise insights to relevant stakeholders.
Communication and Outreach: Write accurate letters and other client-facing communications, conduct outreach to determine appeal statuses, determinations, and explanations, and communicate effectively with members, providers, and customers.
Appeals Meeting: Schedule and run appeals meetings, facilitating discussions among relevant parties to reach resolutions.
Provider Education: Educate providers, members, attorneys, and other stakeholders involved in the appeals process on relevant procedures and requirements.
Administrative Tasks: Oversee administrative tasks, including settling billing issues and maintaining organized appeal files.
Qualifications:
Job Details:
If you have the relevant experience and a keen eye for detail, we invite you to apply for the position of Appeals Coordinator with our dynamic and growing healthcare device company. Join our team in making a difference in the lives of patients and healthcare providers across the country.
Full Time
Scientific Services
$47k-57k (estimate)
08/08/2023
05/28/2024
impact-solutions.co.uk
GRANGEMOUTH, SCOTLAND
25 - 50
2002
KEVIN ROSS
<$5M
Scientific Services
The job skills required for Appeals Coordinator include Life Insurance, Customer Service, Billing, Health Insurance, Communicates Effectively, Claim Processing, etc. Having related job skills and expertise will give you an advantage when applying to be an Appeals Coordinator. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Appeals Coordinator. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Appeals Coordinator positions, which can be used as a reference in future career path planning. As an Appeals Coordinator, it can be promoted into senior positions as an Appeal Resolution Senior Specialist that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Appeals Coordinator. You can explore the career advancement for an Appeals Coordinator below and select your interested title to get hiring information.