Medical Appeals Specialist - AZ Licensed
Job Summary
A company is looking for a Med Appeals and Grievance Specialist II (remote).
Key Responsibilities
- Research and resolve member and provider appeals, grievances, and corrected claims
- Analyze medical records to determine the appropriateness of requests based on medical necessity and benefit plans
- Maintain accurate records and meet regulatory and compliance timelines
Required Qualifications
- Associate's Degree in a healthcare field or Nursing Diploma
- Active, unrestricted license to practice in Arizona as an RN, PT, or LMSW
- 3 years of experience in clinical and health insurance or healthcare-related field
- 1 year of managed care experience with a focus on Utilization Management, Prior Authorization, Claims, or Medical Appeals
- Intermediate PC proficiency and ability to navigate multiple system applications
COMPLETE JOB DESCRIPTION
The job description is available to subscribers. Subscribe today to get the full benefits of a premium membership with Virtual Vocations. We offer the largest remote database online...
Company Overview
Company Company Name
Headquarters Headquarters
Founded Founded
Website
Wikipedia Wikipedia URL
BBB URL BBB URL
The company description is available to subscribers. Subscribe today to get the full benefits of a premium membership with Virtual Vocations. We offer the largest remote database online...
BECOME A PREMIUM MEMBER TO
UNLOCK FULL JOB DETAILS & APPLY
- ACCESS TO FULL JOB DETAILS AND APPLICATION INFORMATION
- HUMAN-SCREENED REMOTE JOBS AND EMPLOYERS
- COURSES, GROUP CAREER COACHING AND RESOURCE DOWNLOADS
- DISCOUNTED CAREER SERVICES, RESUME WRITING, 1:1 COACHING AND MORE
- EXCELLENT CUSTOMER SUPPORT FOR YOUR JOB SEARCH
