Appeals Specialist I
2 weeks ago
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
Under Supervision, This Position Is Responsible For Processing, Organizing, And Coordinating All Materials And Information Relating To Processing Appeals For All Lines Of Business Following Federal, State, And Accreditation Requirements; And For Accurately Responding By Telephone, In Person, Or Through Correspondence To All Inquiries Involving Requests For Appeals From Members, The Department Of Labor, Or Erisa, Providers, Or A Member Authorized Representative; Sending Letters And Updates According To The Case Requirements; And Entry Of Appeals Into The Appropriate Database. Ability To Travel, Including Overnight Stays.JOB REQUIREMENTS:
* High School Degree or GED.
* 1 year experience in a customer service role in a health insurance or medical environment
* Analytical, problem solving and research skills.
* Organizational skills to accommodate large volume of reference materials combined with time management skills to achieve accessibility to callers.
* Verbal and written communication skills to clearly express oneself in a well-modulated tone with correct grammar and attention to enunciation.
* Experience working both independently and in a team environment to meet deadlines according to regulations
* Ability to travel, including overnight stays
PREFERRED JOB REQUIREMENTS:
* BlueChip claims payment experience.
* Medical terminology.
* Knowledge of appeals processing.
* Ability to think clearly and maintain a professional, poised attitude under pressure.
* Detail oriented.
* Bi-lingual Spanish speaking.
HCSC Employment Statement:
We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
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