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