Appeals Specialist

A company is looking for an Appeals Specialist I (Remote).

Key Responsibilities

Prioritize, research, and analyze appeal requests, ensuring accurate data entry and case assignment

Utilize professional communication to respond to appeals while maintaining confidentiality and compliance with regulations

Assist supervisors and other specialists with unit projects and provide feedback for workflow improvement

Required Qualifications

High School Diploma or GED

3 years of experience in managed care, health care, or insurance payor environments

Preferred : College degree

Knowledge of medical terminology

Experience with CareFirst systems or related services is a plus