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Appeals Specialist Jobs
Company | Kepro |
Address | Cary, NC, United States |
Employment type | FULL_TIME |
Salary | |
Category | Technology, Information and Internet |
Expires | 2023-09-14 |
Posted at | 9 months ago |
- Are you motivated, energetic, and excited to become part of the Kepro team?
- Do you value care management and quality improvement?
- Are you an experienced Appeals Specialist looking for a new challenge?
- Schedule follow-up assessments for clinical staff related to a reassessment
- Verify adverse decision notifications were handled and documented, per protocol
- Other duties as assigned
- Prepare and disseminate mailed correspondence
- Track scheduling, decisions, dates and outcomes related to the appeal in the appropriate databases
- Support clinical staff with scheduling to attend and preparing their testimony for mediations and appeals
- Support development and maintenance of business processes related to mediation and appeals processes
- Coordinate with the Officer of Administrative Hearings and mediator in scheduling and conducting mediations and appeals
- Requires high school diploma or GED
- Associates degree from a business or secretarial school desirable
- Basic data entry skills
- Must be able to review and prepare case mediation and appeal documentation
- Ability to meet departmental standards
- Highly organized
- Must be able to research and resolve decisions, outcomes of mediations and appeals
- Excellent customer service skills
- Excellent verbal and written communication skills.
- Previous experience in the health care industry preferred
- Requires 3+ years’ customer service experience.
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