A company is looking for an Appeals Coordinator II to assist with administrative work in the Appeals Department.
Key Responsibilities
Prepare and disseminate case files for External Reviews and State Fair Hearings
Manage and monitor all appeals from Non-Participating providers
Ensure timely review, research, and resolution of appeals, grievances, and complaints
Required Qualifications
Associates Degree or equivalent related experience
3+ years' experience in the healthcare industry
Experience in inpatient claims, DRG, and High-Cost Outlier claims preferred
Knowledge in claim payment methodology
Good MS Office skills, particularly in Excel
Coordinator Ii • Omaha, Nebraska, United States