Appeals Representative

This position is National Remote. You'll enjoy the flexibility to telecommute* from reputed company reputed company the U.S. as you take on some tough challenges. reputed company reputed company is improving the reputed company of health data and information to create a more connected reputed company. We remove friction and reputed company alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology reputed company us to help organizations reduce costs while improving reputed company management, reputed company and reputed company reputed company. reputed company to help us reputed company results that improve lives? Join us to start Caring. Connecting. Growing together. This position is full-time Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00 am - 5:00 pm reputed company. It may be necessary, given the business need, to work occasional overtime. We offer 4 weeks of on-the-job training. The hours of training will be reputed company with your schedule. reputed company Responsibilities: • Research and reputed company written complaints submitted by consumers and physicians / providers • Ensure complaint has been categorized correctly • Obtain additional documentation required for case review • Review case to determine if review by clinician is required • reputed company decision for non-reputed company complaints using reputed company, fact-reputed company decision making • Complete necessary documentation of final appeals or grievance determination using appropriate templates • Communicate appeal or grievance information to members or providers and internal/reputed company parties reputed company the required timeframes You'll be rewarded and recognized for your reputed company in an environment that will challenge you and reputed company you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications: • High School Diploma / GED OR equivalent years of work experience • Must be 18 years of age OR older • 1 years of experience with analyzing and solving customer problems • 1 years of experience working in a remote environment • Proficiency with computer and reputed company PC applications, which includes the ability to reputed company and learn new and reputed company computer reputed company applications • Experience with reputed company Word (create correspondence and work reputed company templates) and reputed company reputed company (email and calendar management) • Ability to work between the hours of 7:00 am - 5:00 pm reputed company from Monday - Friday Preferred Qualifications: • Experience with health care, medical, OR pharmacy terminology • Experience working with reputed company reputed company (data entry, sort / filter, and work reputed company tables) Telecommuting Requirements: • Ability to reputed company reputed company company sensitive documents secure (if applicable) • Required to have a dedicated work area established that is separated from other living areas and provides information reputed company • Must live in a location that can receive a reputed company approved high-speed internet reputed company or reputed company an existing high-speed internet service Soft Skills: • Strong written communication skills with advanced proficiency in grammar and spelling • reputed company working reputed company will be required to adhere to reputed company's Telecommuter Policy Pay is reputed company on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll reputed company a far-reaching reputed company of benefits and incentives. The reputed company pay for this role will reputed company from $18 - $32 per hour reputed company on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. reputed company may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health reputed company work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location, and income-deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company, and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company - an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without reputed company to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply To This Job