Clinical Appeals Reviewer

Job Summary

A company is looking for a Clinical Appeals Reviewer.

Key Responsibilities

• Review, research, investigate, and resolve appeals
• Understand appeals process rules, regulations, and compliance expectations
• Proactively identify solutions to non-standard requests and maintain data entry accuracy

Required Qualifications

• High School Diploma / GED or equivalent work experience
• 1+ years of experience in a healthcare setting with knowledge of health insurance processes
• 1+ years of experience managing high-volume outbound calls in a fast-paced environment
• Data entry experience with large volumes of data into software systems
• Experience with Microsoft Office, including Outlook and Excel