Care Coordinator Appeals
Job Description
The Care Coordinator - Appeals is responsible for supporting health plan, physicians and member requests related to appeals, and scheduling peer to peer conversations. You will be responsible for tracking and monitoring turnaround times to assure service requirements are met. Participation in the collection and documentation of all required data to meet the requirements of the client. Responsibilities Provide focused resolution, support, and information to customers by embracing CareCentrix Values. Manage cases and requests for services in a timely and accurate manner; collection, verification, and confirmation of non-clinical information and issue escalation. Negotiate with providers when needed and stay within the URAC guidelines. Qualifications High School Diploma or the equivalent plus a minimum of one year medical terminology or medical services experience required. Experience in a call center environment required. Minimum of two years insurance, quality improvement or healthcare operations required. Must have knowledge of basic spreadsheet, word processing, and data entry skills. Must be proficient and comfortable in a computer based environment.
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Job Detail
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Job IdJD3160397
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IndustryNot mentioned
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Total Positions1
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Job Type:Full Time
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Salary:Not mentioned
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Employment StatusPermanent
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Job LocationIndia, India
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EducationNot mentioned
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ExperienceYear