Non-Clinical Health Coordinator

Job Summary

Providing support to members and clinicians, the remote Physical Health Coordinator (Appeals Non-Clinical) will manage inquiries, process physical health clinical appeals, and assist in resolving issues while maintaining compliance with departmental policies.

Key responsibilities

• Receive and respond to inquiries from customers, clinicians, or physicians regarding physical health appeals
• Distribute appeals to clinicians and maintain production requirements to support the Appeals Department
• Research appeal processes and communicate necessary information to members and providers

Required qualifications

• 1 or 2 years of college education or 3 years of experience with automated systems
• Experience in coordinating member needs and analyzing member requirements
• Knowledge of medical terminology
• Proficiency in database management or PC applications
• Strong customer service skills