Appeals Specialist

Renton, WA 98055 | Temp/Contract

Job ID: 00003PGZ Job Category: HEALTHCARE - Coding.Billing. Claims Pay Rate: 18.00
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.

Job Duties:
* 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.
* Experience working in the healthcare industry
* Detailed oriented with great work ethic
* Ability to research medical coverage, claims and authorizations
* Ability to multi task
* Intermediate Excel, Outlook and and computer navigation skills

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