Utah Licensed Appeals Specialist

Job Summary

Working remotely in a full-time capacity, the Utah Licensed Appeals Specialist will be responsible for researching and appealing denied medical claims, identifying denial trends, and collaborating with various departments to enhance the appeals process.

Key responsibilities

• Research and appeal denied medical claims using knowledge of contracts and laws
• Identify trends in insurance denials and collaborate with multidisciplinary teams to improve denial management
• Prepare appeals and support legal counsel for Administrative Law Judge hearings

Required qualifications

• Demonstrated experience in a healthcare revenue cycle role
• Proficiency in Microsoft Office and other computer skills
• Exceptional written communication skills
• Knowledge of State/Federal/ERISA and self-funded insurance laws