Administrative Appeals Coordinator

Job Summary

A company is looking for an Administrative Appeals Coordinator.

Key Responsibilities:

• Counts and logs member and claim data, generating appeal claim identification numbers and files
• Assists claim appeal analysts with retrieving completed files and responds to inquiries on the Claim Appeal Hotline
• Educates providers and billing agencies on Medicaid Operations appeal processes and recommends improved business processes

Required Qualifications:

• High School Diploma/GED required
• Minimum of one year customer service and/or healthcare experience, preferably in a Health Maintenance Organization and/or Managed Care environment
• Preferred one year experience in the research of complaints or appeals
• Preferred knowledge of Medicaid Managed Care and Traditional/Indemnity insurance industries
• Preferred knowledge of medical terminology