Appeals Coordinator

Job Title: Appeals Coordinator
Location: Remote, NY 12207
Duration: 6+ Months Contract
 
Pay Rate: $17.20/hr. on W2

Location: Remote
Time Zone: EST
Hours of Operations: 8:00 am - 5:00 pm

Type: Long Term Assignment (9-12 months) for now
Interview Process: TEAMS
 
Job Description – Essential Duties and Responsibilities

• Function as a Subject Matter Expert in one or more process areas.
• Analyze data submitted for Independent Medical Review.
• Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
• Track and meet required deadlines for complex cases or other assigned tasks.
• Assist leadership through research of data and/or authoring reports.
• Analyze data using all applicable state law, state regulations, process documents, and other sources as defined by the client contract.
• Work independently on specific situations or on a team to resolve problems and deviations according to current established practices; and obtain advice where precedents are unclear or not available from the client.
• Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
• This position may assist others or provide on-the-job training or act as a mentor to production staff.

 
Minimum Requirements

• High School diploma or equivalent required.
• 2-4 years of related experience.

 
Critical Skills Needed for this Position

• Computer literacy.
• Active participation with TEAMS/Zoom environment.
• Attention to details.
• Typing - 25 wpm.
• Ability to communicate in a professional work environment whether in remote or in person.
• Ability to work in a team environment.
• Ability to multitask.
• Can do attitude.
• Professionalism.