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Appeals Representative
A company is looking for an Appeals Representative. Key Responsibilities Entering new cases in the QI Database Writing queries and requesting responses/medical records from providers/offices Reviewing responses and preparing cases for clinician review Required Qualifications Experience with processing health plan grievances and UM authorizations preferred Proficient in Microsoft Excel, Word, and Teams Must have a good internet connection for Telework Live in the PST time zone, with a preference for the SoCal area Administrative skills and experience in processing grievances desired
A company is looking for an Appeals Representative.
Key Responsibilities
Entering new cases in the QI Database
Writing queries and requesting responses/medical records from providers/offices
Reviewing responses and preparing cases for clinician review
Required Qualifications
Experience with processing health plan grievances and UM authorizations preferred
Proficient in Microsoft Excel, Word, and Teams
Must have a good internet connection for Telework
Live in the PST time zone, with a preference for the SoCal area
Administrative skills and experience in processing grievances desired