Tennessee Licensed Market Appeals Specialist

Job Summary

A company is looking for a Lead Market Appeals Specialist to support utilization management and shared services within the behavioral health division.

Key Responsibilities

• Complete all standard appeals timely and manage appeal inventory through ongoing tracking and monitoring
• Act as a liaison with local facilities and payers to ensure timely appeal processing and appropriate follow-up for facility reimbursement
• Supervise, guide, and support the Appeals Support Specialist within the Market

Required Qualifications

• Bachelor's degree required, Master's preferred
• RN License or Master's level clinician required
• 3-5 years related experience required, 5-8 preferred
• Knowledge of utilization management operations, including experience with appeal letters and payer engagement
• Proficient in Excel, Microsoft Office/Teams, Word, and database inventory management