UM Appeals Analyst

Job Summary

A company is looking for a UM Appeals Analyst - MAC.

Key Responsibilities

• Review service requests for completeness and manage initial screening for UM Appeals requests
• Prepare and present cases for the Member Appeals Committee and facilitate communication among involved parties
• Mentor junior staff and assist in developing training for proper appeal handling

Required Qualifications

• High School Diploma/GED required
• Minimum of 5 years healthcare industry or operations experience
• Minimum of 3 years direct customer service experience, preferably in a medical support role
• Preferred experience with prior appeals handling and correspondence
• Knowledge of medical terminology and Managed Care principles preferred