Healthcare Appeals Specialist

7 days ago


Orlando, Florida, United States Aspire Health Partners Full time
Job Title

Healthcare Appeals Specialist

About Us

We are Aspire Health Partners, a leading non-profit behavioral health company in the Southeast. With over 50 years of experience, we provide state-of-the-art behavioral healthcare to nearly 40,000 clients annually across six Central Florida counties and expanding into Hinesville, Georgia.

Our mission is to deliver compassionate, comprehensive, and cost-effective integrated behavioral healthcare. We strive to transform lives and communities through innovative treatment approaches.

Estimated Salary Range

$60,000 - $80,000 per annum, based on location and experience.

Job Responsibilities
  • Review and resolve insurance claims denied or disputed by carriers due to lack of authorization or medical necessity.
  • Manage medication prior authorizations to ensure timely and efficient administration.
Required Skills and Qualifications
  • Bachelor's degree in Healthcare, Nursing, Performance, Law, Business, Management, or related field.
  • RN or LPN with Behavioral Health experience preferred.
  • Level II Background clearance required.
  • Ability to multitask, prioritize tasks, and meet deadlines.
  • Strong analytical/deductive skills, mathematical analysis, and problem-solving abilities.
  • Familiarity with EHR systems and data manipulation using Microsoft Excel and other Office products.
  • 3+ years of experience initiating appeals with Managed Care or Commercial Payors for reimbursement.
  • Utilization and/or Case Management experience recommended.
Benefits
  • Comprehensive benefits package including medical, wellbeing, dental, and vision coverage.
  • Paid Time Off (PTO) and Paid Diversity Holidays.
  • 403(b) 50% employer match up to 10% with 3-year vesting cliff.
  • Employee Discounts and Travel Assistance.
Grow with Us

At Aspire Health Partners, we offer a supportive community of health professionals and opportunities for career growth. If you're a leader looking for a new challenge, apply today



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