Review & Appeals Specialist I

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Voted one of the Best Places to Work in Healthcare

4 years in a row by Modern Healthcare!

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NCCPA requires all employees to be fully vaccinated against COVID-19 as of December 15, 2021, unless the employee qualifies for a legally required exemption. New hires must provide proof of full COVID-19 vaccination at the time of hire, and offers of employment will be contingent on compliance with NCCPA’s COVID-19 vaccination policy.

Review & Appeals Specialist

Location: NCCPA is a hybrid work environment with our headquarters located in Johns Creek, Georgia. NCCPA has determined that the telecommuting status of this position is hybrid which means that employees in hybrid positions are allowed to split their work hours between work remotely and working onsite at the NCCPA headquarters.

Reports To: Director of Review and Appeals

Who We Are

NCCPA is the only certifying organization for physician assistants in the United States. Established as a not-for-profit organization in 1975, we are dedicated to assuring the public that certified PAs meet established standards of clinical knowledge and cognitive skills upon entry into practice and throughout their careers. All U.S. states, the District of Columbia and the U.S. territories have decided to rely on NCCPA certification as one of the criteria for licensure or regulation of PAs.

Why Work at NCCPA

We get to do meaningful work every day and we enjoy working and having fun together! No wonder we’ve been voted one of the Best Places to Work in Healthcare by Modern Healthcare 4 years in a row!

Our Team

The Review & Appeals Team works diligently to manage and support NCCPA's Disciplinary and Exception to Policy cases. We are a team of highly organized, proficient multi-taskers with a great attention to detail.

Why Us, Why Now?

As a Review and Appeals Specialist I you will work as an integral part of our dynamic team to review disciplinary notifications, exception to policy requests, re-establishment requests and complaints.

How Will You Make a Difference? You will…

• Maintain responsibility for the accuracy and integrity of the review and appeal data, outgoing correspondence, case review recommendations, and related applications.
• Review incoming disciplinary notifications from internal and external entities, exception to policy requests, re-establishment requests and complaints. Identify issues that require additional investigation, validate discrepancies and ensure appropriate follow up.
• Maintain ongoing knowledge regarding NCCPA organizational policies, departmental policies, standard operating procedures, operational guidelines, business rules, reports and audit tools.
• Critically analyze acquired documentation to create a summary of findings, in accordance with established timeframes, standard operating procedures, and organizational policies.
• Prepare cases for external reporting to the Federation of State Medical Board and associated licensing boards.
• Maintain a professional rapport with internal and external parties (i.e. FSMB, state licensing boards, physician health programs, Physician Assistants, team members).

Hard Skills You Will Have

• An ability to read and interpret organizational policies, procedures, legal, and state medical board documentation.
• Strong proficiency in Microsoft Office applications especially in Word, Outlook, Excel, Power Point, and Adobe Acrobat.
• Your proven analytical approach and proactive problem-solving skills that identify and recommend solutions to the determined issues.
• An Associate degree preferably in Business, Legal Studies or healthcare related field. A higher level of work experience in the related field may be substituted for education.

Soft Skills You Will Bring

• Your proven ability to manage competing priorities and accomplishing tasks within the agreed upon timeframe.
• Your ability to work in a fast-paced environment as a self-motivated team member.
• Your highly developed time management skills, systematic approach to organization/planning and keen attention to detail.
• Your excellent written and verbal communications skills with a proficiency in diplomacy and confidentiality.
• Your ability to provide exceptional customer service and interact with both internal and external customers in a timely, positive and professional manner.

Extra Skills You Can Bring Along

• At least two years of professional experience in business, healthcare, appeals & grievances, state medical board or legal field.
• A Bachelors degree or currently working towards completion.

Compensation Range: $52,007.00 - $57,000.00

Benefits And Perks For You

• $1,000 Annual Reimbursement for Fitness Clubs & Program Dues
• Up to $240 in Annual Cash Incentives for Staying Active
• Health Reimbursement Account for Medical Expenses (100% Employer Funded)
• Great Compensation
• Flexible Work Hours and Hybrid Work Environment
• Eleven paid holidays
• Work/Life Balance
• 100% Employer Paid Training Opportunities
• Monthly Technology Stipend
• Fully Stocked Breakroom with Healthy Snacks
• $5,250 in Tuition Reimbursements
• Paid Volunteer Day to Make a Difference
• 19 PTO Days
• Medical, Dental and Vision with over 80% Employer Contribution
• Access to Voluntary Benefits such as Legal Aid, Critical Illness, Accident Insurance, and Basic Life and AD&D for you, your spouse and dependents
• 401(k) Plan with Employer Contributions and Matching
• 24/7 Telehealth
• Flexible Spending Accounts for Medical and Dependent Care Expenses
• 100% Employer Paid Group Life Insurance and Short- and Long-term Disability
• 37.5-hour workweek, Monday - Friday
• Employee Assistance Program

We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace.

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