Do you have experience working in healthcare and researching claims and/or appeals?
Our client, a large healthcare and insurance provider located in Renton, is looking for up to 2 Appeals Specialists for a 3 month long assignment.
* Triage and document requests for member appeals
* Manage complaints via phone, fax, email and U.S. Mail
* Case research on medical coverage, claims, authorizations, clinical reviews, eligibility
* Interpretation of legal documents
* Provide appeal process guidance
* Provide requirements to members, prospective members, providers, insurance agents, brokers, attorneys, etc.
* Answer high volume of complex calls with members and providers
* Interpret needs of caller in order to assist them appropriately
* Prepare all materials for case reviews in line with regulatory requirements
* Prepare materials and ongoing support for the Appeal Coordinator
* Our client has a drug free workplace, and abides by federal law identifying marijuana as an illegal substance. All candidates must pass a drug test and background check prior to being hired on for an assignment.