The Care Coordinator – Appeals is responsible for supporting health plan, physicians and member requests related to appeals, and scheduling peer to peer conversations. You will be responsible for tracking and monitoring turnaround times to assure service requirements are met. Participation in the collection and documentation of all required data to meet the requirements of the client.
Schedule after training: Monday – Friday, 9:00a – 5:30p EST
Responsibilities
- Provide focused resolution, support, and information to customers by embracing CareCentrix Values.
- Manage cases and requests for services in a timely and accurate manner; collection, verification, and confirmation of non-clinical information and issue escalation.
- Negotiate with providers when needed and stay within the URAC guidelines.
Qualifications
- High School Diploma or the equivalent plus a minimum of one year medical terminology or medical services experience required.
- Experience in a call center environment required.
- Minimum of two years insurance, quality improvement or healthcare operations required.
- Must have knowledge of basic spreadsheet, word processing, and data entry skills.
- Must be proficient and comfortable in a computer based environment.
What we offer:
- Starting Pay for external hires is $17.00/hr + Incentive Bonus Opportunity. The pay range included in this posting reflects future growth / earning potential.
- Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match
- Generous PTO, 401K Savings Plan, Paid Parental Leave, free on-demand Virtual Fitness Training and more
- Advancement Opportunities, professional skills training, and tuition /exam reimbursement
- PayActiv – access earned income in between pay checks
- Walgreens Discount – receive up to 25% off eligible items
- Great culture with a sense of community