Clinical Appeals Reviewer

Job Summary

A company is looking for a Clinical Appeals Reviewer - National Remote.

Key Responsibilities:

• Manage administrative intake of members
• Collaborate with hospitals, clinics, and the clinical team to manage service requests
• Process referrals and prior authorizations, including intake and resolution of inquiries

Required Qualifications:

• High School Diploma / GED or equivalent experience
• Must be 18 years of age or older
• 2+ years of customer service experience
• Experience in the healthcare industry or medical settings
• Proficient with Windows-based programs, including Microsoft Word, Excel, and Outlook