Appeals Coordinator- Remote

About the role

The Appeals Coordinator at Lifepoint Health supports patients and community members interfacing with the organization’s facilities. This role involves gathering necessary information for appeals, writing and submitting appeals to insurance companies, and maintaining documentation.

Responsibilities

• Gather all information required for an appeal, write, and submit the appeal to the insurance company.
• Maintain documentation of all steps taken and follow up on appeal status via phone calls and tracking systems.
• Interface with managed care organizations, external reviews, and other payers to ensure appeals are completed thoroughly and on time.
• Utilize provider portals to submit appeals and check on the status of appeals.
• Communicate with facility UR staff to efficiently complete the appeal process.

Requirements

• Bachelor's Degree in social work, RN, or related behavioral health field.
• Minimum of 2 years of experience in a managed care or healthcare setting.
• Previous utilization review experience in a psychiatric healthcare facility preferred.
• Computer proficiency in Microsoft Office applications and other relevant software.

Qualifications

• Knowledge of clinical pertinence and managed care requirements to support medical necessity criteria.
• Ability to manage large volumes of documents and maintain accurate records.
• Strong communication skills to interact with various stakeholders.

Skills

• Proficiency in Microsoft Office applications.
• Experience with provider portals and electronic health record systems.
• Excellent organizational and problem-solving skills.

Benefits

Comprehensive benefits package including medical, dental, and vision coverage, life and accident insurance, short- and long-term disability, paid time off, and retirement plans.

Pay

Commensurate with experience.

Schedule

Days: M-F

Job Location Type

Remote