Telecommute Healthcare Appeals Representative in Chico

Job is Expired
Location: California
Compensation: To Be Discussed
Staff Reviewed: Thu, Sep 09, 2021

Job Summary

A global healthcare company is searching for a person to fill their position for a Telecommute Healthcare Appeals Representative in Chico.

Candidates will be responsible for the following:

  • Determining and confirming member eligibility and benefits Obtain additional documentation required for case review Log and route appeals Place relevant documents into image repository Initiate outbound contact to members or providers
  • Reviewing case to determine if review by Clinician is required
  • Researching and resolvign verbal and written complaints submitted by consumers and providers

Required Skills:

  • High School Diploma / GED (or higher)
  • 2+ years of experience analyzing and solving appeals and grievances in an office environment using the telephone and computer as the primary instruments to perform job duties
  • Proficiency with computer and Windows PC applications, including MS Office, Excel and Outlook and the ability to navigate and learn new and complex computer system applications
  • Ability to work mandatory overtime between 1 to 20 hours per week as needed
  • Previous experience with creating resolution letters
  • Ability to complete necessary documentation of final appeals or grievance determination using appropriate templates

COMPLETE JOB DESCRIPTION

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