The Utilization Review and Denials and Appeals Process Coordinator is responsible for all clerical aspects of denials and appeals including, but not limited to, processing requests for concurrent or retro reviews. This individual will be a liaison and point of contact to/for PBS, UM and other CHS representatives for denial and appeal inquiries. This individual must be able to work independently and manage customer service and project workflow
LEVEL OF EDUCATION
Preferred: Associate’s or Bachelor’s Degree
TECHNICAL REQUIREMENTS
Minimum: Intermediate MS Excel, Word, Outlook, and PowerPoint skill and proficient Internet skills
Preferred: Proficiency with electronic medical records, databases, and clinical application software
YEARS OF RELATED WORK EXPERIENCE
Minimum: 2 years of clerical experience in a healthcare setting
Preferred: Previous experience in denials and appeals, insurance follow up, and patient financial services
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