Title: Appeals Specialist lll

Duration: 4 months

Remote but candidate must be within DMV

Job Description:

3 to 5 years of experience with healthcare background required

• Provides support and acts as a trainer and mentor to entry level associates including Appeals Specialists I & II.
• Designs and provides effective training programs for internal customers who need education on the appeals process.
• Develops and provides information, training and education for appeals associates at Staff, R &T and Nurse Forums.
• Performs other duties such as committee work and special projects.

QUALIFICATIONS

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
• The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education Level: High School Diploma

Experience: 5 years experience in settings such as managed care, health care or insurance payor environment 3 years experience in Clinical Appeals and Analysis Unit including 2 years experience as an Appeals Specialist II

In Lieu of Education
Preferred Qualifications
College Degree
Knowledge of CareFirst system, Member/Provider Service, Claims or Care Management experience a plus.
Leadership Experience

Job Type: Contract

Pay: $25.00 - $30.00 per hour

Expected hours: 40 per week

Schedule:

• 8 hour shift

Work setting:

• Remote

Work Location: Remote