Appeals Coordinator

6 days left

Location
Virginia Beach, VA
Salary
Competitive
Posted
Jan 08, 2019
Closes
Jan 26, 2019
Ref
119531BR
Function
Administrative
Industry
Healthcare
Hours
Full Time
Overview:

Other
Provider Appeal Coordinator positions require CPC Certification within 1 year of eligibility.

Responsibilities:

Responsible for the investigation and documentation of member appeals and grievances in compliance with State law, applicable rules and regulations and provider and group agreements. Works closely with the Plan's Medical Directors who are responsible for all decision regarding clinical appeals/ grievances and the Appeals Manager who is responsible for non-clinical appeals and grievances.

Qualifications:

Education Level
High School Grad or Equivalent

Experience
Required: Managed Care - 3 years

Preferred: None, unless noted in the "Other" section below

License
None, unless noted in the "Other" section below

Skills
Required: Microsoft Access, Microsoft Excel, Microsoft Word

Preferred: None, unless noted in the "Other" section below

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