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Standard job listing
Title of job: Appeal Specialist - Health Background -
Job Location: San Mateo, California, 94402
Job Type: Contract to Hire
Price Range:
Negotiable, Depending on experience
Start Date:
ASAP
End Date:
Not a pressing concern
Categories:
# Section Category Subcategory
#1 Health Care Health Care Home Healthcare
Qualifications:
, , 3 years experience in healthcare or medical field. Experience processing & adjudicating claims.

Other desired skills:
, , 3 years experience in healthcare or medical field. Experience processing & adjudicating claims.
Job/Project Details: Client is looking for an Appeal Specialist. The Appeal Specialist manages a case once it has been denied by working with the parties involved to formulate an appeal strategy. The objective of this position is to work with the patients, physicians, distributors, clients and insurance companies to get appeals reversed and patients on therapy. It will be the responsibility of the Appeal Specialist to understand and interpret payor guidelines and policies and draft appeal letters on behalf of the parties involved. The Appeal Specialist is also responsible for understanding the clinical information, will have the ability to perform searches for relevant articles while assisting the customer through education and clear communication. Requirements: 3 years experience in Healthcare or a related field. Proficiency in healthcare insurance reimbursement including benefit investigations & appeals. Prior experience processing or adjudicating claims is desired along with strong writing skills. Extremely strong customer service skills along with the ability to multi task, identify reimbursement trends, and meet customer commitments are key. Ability to work in a team environment and successfully work with others to achieve a common goal. Effective problem solving skills, attention to detail and strong verbal skills are also important. Clinical knowledge is preferable but not essential.df-jb

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