Appeals Coordinator

Job Summary

A company is looking for an Appeals Coordinator responsible for reviewing, researching, and resolving appeals while ensuring compliance with regulations and guidelines.

Key Responsibilities

• Reviews, evaluates, documents, and tracks appeal documents, ensuring resolution within established time standards
• Creates and provides quality written responses to appeal requests in a timely manner
• Communicates with members and providers regarding appeal resolutions and prepares case files for Independent Review Entities

Required Qualifications

• High School diploma or equivalent
• 1+ years of appeals-related experience or relevant knowledge and skills
• Strong learning agility and enthusiasm for skill development
• Ability to maintain confidentiality and high ethical standards
• Good computer skills, specifically with Microsoft Office applications