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Health Care Appeals Specialist **REMOTE**

Location : Columbus, OH
Job Type : Contract
Reference Code : 11959
Hours : Full Time
Required Years of Experience : 1-3
Required Education : High School or Equivalent
Travel : No
Relocation : No

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




This role will begin as a Remote position, however, it WILL transition to an onsite role once the office is reopened. There will be no exceptions to this requirement. 



 

ONLY CANDIDATES LOCAL TO THE Columbus, OH, AREA WILL BE CONSIDERED FOR THIS ROLE. 




 

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


Shift is an 8 hour flex schedule from 7 AM EST-6 PM EST.



This is a contract position currently budgeted at $21/hour for 3 months with the potential for contract extension or a permanent hire based on performance!








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.