California Licensed Appeals Administrator

Job Summary

Supporting the review and processing of workers' compensation appeal cases, the full-time California Licensed Appeals Administrator will analyze and enter medical case information, review documentation for accuracy, and assist in the independent medical review process in a fully remote setting.

Key responsibilities

• Analyze data submitted for Independent Medical Review and input necessary information into the system
• Respond to incoming inquiries from clients, health plans, providers, and enrollees regarding case status and the appeals process
• Maintain updated knowledge of project and corporate policies while functioning as a Subject Matter Expert in designated process areas

Required qualifications

• Associate degree with 2+ years of relevant experience, or HS Diploma/GED with 4+ years of experience
• Proficiency in computer usage, including web-based applications
• 2 years of experience in healthcare, medical office administration, or a related field
• Strong analytical skills and attention to detail
• Knowledge of medical terminology and experience with reviewing medical records