CPC Certified Appeals Associate
A company is looking for an Appeals Associate with experience in healthcare appeals and coding disputes. Key Responsibilities Analyze, research, and resolve confidential appeals, coding disputes, and grievances Interpret and explain health plan benefits, policies, and medical terminology to stakeholders Prepare files and develop position statements for external reviews by independent organizations Required Qualifications Bachelor's degree or 5 years of relevant experience in lieu of a degree Certified Professional Coder (CPC) certification required Experience with external review organizations, benefit panels, and medical consultants Knowledge of accreditation standards and state/federal healthcare regulations Strong ability to exercise independent judgment in compliance with healthcare policies
A company is looking for an Appeals Associate with experience in healthcare appeals and coding disputes.
Key Responsibilities
Analyze, research, and resolve confidential appeals, coding disputes, and grievances
Interpret and explain health plan benefits, policies, and medical terminology to stakeholders
Prepare files and develop position statements for external reviews by independent organizations
Required Qualifications
Bachelor's degree or 5 years of relevant experience in lieu of a degree
Certified Professional Coder (CPC) certification required
Experience with external review organizations, benefit panels, and medical consultants
Knowledge of accreditation standards and state/federal healthcare regulations
Strong ability to exercise independent judgment in compliance with healthcare policies
