Remote – Appeals Coordinator (WA – Remote)

Workforce Connections

April 24, 2024

Mountlake Terrace,

Job Title: Appeal Coordinator

Contract Duration: 9+ months

Pay Rate: $22-24 (based on experience)

Location: Remote – PST time

Work Hours: 11:00- 8:00pm EST

Qualifications/Skills Needed

Required Skills/Experience:

Preferred Skills/ Experience

Need to have some sort of medical office, billing, coding, etc.

TruCare, Peer to Peer, Appeals

CPT, ICD-10 codes are required to know

Call Center Experience (healthcare) Medicaid / Marketplace experience is a bonus.

Education Requirement

High School Diploma

Education Preferred

High School Diploma

  • Need to have a background working within the medical field.
  • Need to have a high-level knowledge of appeals.
  • CPT, ICD-10 codes are required to know
  • Ability to work in highly productive environment
  • Team is ever evolving; this person must be able to go with the flow and adapt

Day To Day Responsibilities Of Role

  • Reviewing denial requests to see if they require a clinical review or medical criteria.
  • Using multiple systems to review appeals
  • Taking calls for peer to peer based on denial letter that are generated.
  • On average this person would be handling inbound / outbound calling (10-20 calls approximately per day)

Performance Expectations

  • Quality and Quantitively with Productivity.
  • Would be given a goal and would be expected to meet after training takes place.
  • This person must be able to send out Microsoft Calendar Invite.

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