Appeals Coordinator
Artech Information Systems LLC
We are currently seeking a "Appeals Coordinator" for a Contract role with one of our clients based in Phoenix, AZ. Please apply if you would be interested and available for it.
Duration: 04+ Months ContractLocation: Phoenix, AZ / Onsite
Job Description :
- Experience in claims processing, medical/ pharmacy precertification, appeals and grievances coordination or other applicable related work experience.
- Perform analysis and research of requests received for medical grievances, appeals for final resolution or referral to the Clinical Medical Appeals and Grievance (MAG) Staff.
- Maintains advanced end user knowledge of multiple systems including vendor medical management and claims systems.
- Review medical records to determine if records satisfy the requested or supporting information required.
- Maintain current medical terminology knowledge.
- Perform data corrections and initiate adjustments related to appeals originating from the Medical Grievance and Appeals Department.
- Communicate decisions through appropriate system updates.
- Demonstrates commitment to excellent customer experience.
- Attest to training competency related to medical terminology and new/revised processes.
- Ensure HIPAA compliance/PHI privacy.
- Assists with research and preparation of appeals files for accreditation site visits.
Raksha Saxena
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Vacancy posted 2 days ago
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