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Appeals Specialist

Location : Columbus, OH
Job Type : Contract
Reference Code : 7652
Hours : Full Time
Travel : No
Relocation : No

Job Description :
Excellent opportunity with a Healthcare provider in Columbus, OH. 



Manages submission, intervention and resolution of appeals, grievances, and/or complaints from Client members and related outside agencies as a part of the integrated Healthcare Services Team



Must have requirements: Claims experience


Day to day responsibilities: Create cases in our main system using information provided on the claim reconsideration requests as well as information researched in the actual claim denial. Then triages those created cases to determine if they are eligible for review based on timely filing guidelines and individual provider contract exceptions. Will then route the cases accordingly based on determination.


Minimum years of experience: 1 year experience in Claims
Work Shift hours: 8 hours Monday – Friday. Typically 7:30 – 4:00 or 8:00 to 4:30
Required Qualifications :
 
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* Your eligibility for benefits depends upon your placement, hours billed and length of service. Your recruiter can identify the programs for which you are eligible. The Company reserves the right to modify or eliminate any of its non-legally mandated benefits at any time.