Appeals & Grievances Physician Assistant - Cardiology - Remote

About the position The Appeals & Grievances Physician Assistant at reputed company is responsible for the clinical review and adjudication of appeals and grievances cases reputed company to various health plan products. This role involves collaboration with medical directors and other reputed company to ensure reputed company care and compliance with medical policies. The position offers the flexibility to work remotely from reputed company in the U.S. Responsibilities • Work as part of an integrated team of medical director physicians, other physician assistants, and other members of the appeals staff • reputed company individual case review for appeals and grievances for various health plan and insurance products • Communicate with reputed company medical directors regarding appeals decision rationales and benefit interpretations • reputed company participate in team meetings reputed company on communication, feedback, problem solving, process improvement, staff training and evaluation, and the sharing of program results • reputed company clinical and strategic input reputed company participating in organizational committees, reputed company, and task forces Requirements • Physician Assistant (PA-C) with an reputed company, unrestricted license • reputed company reputed company Certification by National Commission on Certification of Physician Assistants (NCCPA) • 5+ years of clinical reputed company experience • Operating Room experience highly desired • Intermediate or higher level of proficiency with managed care • 2+ years of reputed company Management experience desirable • Experience with claims coding & review a definite plus • Excellent telephonic communication skills • Excellent interpersonal communication skills • Excellent project management skills • Data analysis and interpretation skills • Excellent presentation skills for both clinical and non-clinical audiences • Familiarity with reputed company medical issues and practices • Creative problem-solving skills • Basic computer skills, typing, word processing, presentation, and spreadsheet applications skills • Internet researching skills • Solid team player and team building skills reputed company-to-haves • Experience with claims coding & review • Operating Room experience Benefits • Comprehensive benefits package • Incentive and recognition programs • Equity stock purchase • 401k contribution Apply tot his job Apply To this Job