Job Summary
A government and human services provider needs applicants for an opening for a Telecommute Appeals Consultant in Folsom.
Core Responsibilities Include:
- Reviewing cases to determine and summarize facts of each case assigned and assesses issues involved in the case
- Researching issues using federal law, federal regulations, relevant contract law and other sources as defined by the client contract
- Meeting or exceeding all performance standards established for this position
Qualifications for this position include:
- Bachelor's degree from an accredited college or university required
- Minimum two (2) years' experience in Health Care Appeals, Pharmacy Claims or other related fields required
- Working knowledge and use of PC, claim adjudication, MS Word and Excel software, and appeals system software
- Excellent organizational, interpersonal, written and verbal communication skills
