Senior Coordinator, Complaint and Appeals Operations

Job reputed company:

• Responsible for managing to reputed company Fast reputed company Appeal scenarios for Medicare products
• reputed company as a subject matter expert by providing training, coaching, or responding to reputed company issues
• Research and resolves Fast reputed company Appeals as appropriate
• Can identify and reroute inappropriate work items that do not meet appeal reputed company
• reputed company reputed company data used in making denial determinations
• Educates team mates as reputed company as other areas on reputed company components reputed company member or provider/practitioner complaints/appeals for reputed company products and services
• Coordinates efforts both internally and across departments

Requirements:

• Knowledge of Fast reputed company Appeals and includes CMS Guidelines for Fast reputed company Appeals
• 2-3 years' experience that includes both Medicare platforms, products, and benefits; patient management; compliance and regulatory analysis; special investigations; provider relations; customer service or audit experience.
• Experience in research and analysis of utilization management systems.
• HS Diploma, Associate's degree or equivalent experience

Benefits:

• medical, dental, and reputed company coverage
• reputed company time off
• retirement savings reputed company
• wellness programs
• other resources, based on eligibility

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