Oregon Licensed Healthcare Appeals Specialist

Job Summary

A company is looking for a Healthcare Appeals Specialist.

Key Responsibilities

• Lead end-to-end processing of provider billing disputes and appeals
• Conduct comprehensive reviews of claims, coding, and reimbursement guidelines
• Collaborate with internal stakeholders to ensure accurate and timely determinations

Required Qualifications

• Minimum of 4 years of experience in healthcare claims, appeals, or clinical support
• Strong knowledge of medical terminology, anatomy, and coding systems
• Demonstrated ability to analyze complex information and make data-driven recommendations
• Experience working with claims processing systems and proficiency in Microsoft Office tools
• Coding certification preferred but not required