Appeals Specialist II
Job Summary
Managing and processing healthcare or insurance claims appeals, the Appeals Specialist II will work remotely to review case files, communicate with providers and patients, and maintain detailed records of case activities.
Key responsibilities
- Manage and process appeals related to healthcare or insurance claims
- Review case files for eligibility and compliance with policies and regulations
- Communicate with providers and patients to gather documentation and clarify information
Required qualifications
- Experience in healthcare or insurance claims processing
- Knowledge of appeals processes and relevant regulations
- Ability to assess appeals for validity and escalate complex cases
- Strong organizational skills for maintaining detailed records
- Remote work capability with compliance to submission protocols
Complete Job Description
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