Clinical Appeals Consultant
virtual vocationsDenver, CO
Clinical Appeals Consultant
L5
virtual vocationsDenver, COtoday
Industries
Offices of PhysiciansAll Other Outpatient Care CentersAll Other Miscellaneous Ambulatory Health Care ServicesWorking remotely in a full-time capacity, the Clinical Appeals Consultant will serve as a key clinical resource for the Appeals & Grievances department, providing support to the Analyst team and collaborating on complex appeals and grievances to enhance member satisfaction.
Key responsibilities:
Serve as a clinical resource for various aspects of Appeals & Grievances work
Support the Analyst team in understanding medical terminology and provider plans of care related to appeals
Analyze appeal trends and collaborate with leadership to develop messaging for internal stakeholders
Required qualifications:
Strong understanding of Appeals & Grievances processes in a managed care environment
Experience with Commercial plans and Medicaid
Ability to work independently and collaboratively in a team setting
Clinical knowledge relevant to assessing and consulting on appeals and grievances
Experience in training or mentoring related to clinical aspects of Appeals & Grievances work
Apply now (opens in a new tab)
Level
SeniorL5
Location
Denver, CO
Occupation
Patient Representatives
Industry
Offices of Physicians
Posted
today
To get sharper similar jobs, create your profile using the link below.