Commercial Appeal Coordinator

A company is looking for a Commercial Appeal Coordinator. Key Responsibilities Investigates and resolves member appeals in a timely manner according to departmental processes and state guidelines Monitors appeals for trends and potential service improvement opportunities Processes member correspondence and performs claims and coding research to identify trends Required Qualifications 2-4 year degree or equivalent education and work experience 2-3 years of customer service, claims, or related experience, with at least 1 year in a health insurance environment Extensive knowledge of managed care, health care benefits, and claims payment processes Behavioral Health and Substance Abuse experience preferred Ability to maintain discretion with confidential member medical information

Mar 26, 2025 - 20:30

A company is looking for a Commercial Appeal Coordinator. Key Responsibilities Investigates and resolves member appeals in a timely manner according to departmental processes and state guidelines Monitors appeals for trends and potential service improvement opportunities Processes member correspondence and performs claims and coding research to identify trends Required Qualifications 2-4 year degree or equivalent education and work experience 2-3 years of customer service, claims, or related experience, with at least 1 year in a health insurance environment Extensive knowledge of managed care, health care benefits, and claims payment processes Behavioral Health and Substance Abuse experience preferred Ability to maintain discretion with confidential member medical information