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Seeking Resolution Coordinators!

Industry

Health and Safety

Advert ID

USA_396074

Location

Durham

Job Type

Contract

Hours

Full-Time

Salary Range

No. of Openings

1

Branch Information

Raleigh - Durham NC Area - (USA) 430 Davis Drive Suite 100 NC Morrisville , NC - 27560 Phone : 855-591-7454

ContactNumber

855-591-7454

Job Description

Large Health Insurance company is looking to hire 10 Resolution Coordinators.



**Previous Medical Claims experienced is required**



Responsible for coordinating and assigning dispositions of Level 1 Appeals, Provider courtesy reviews and Provider coding reviews. Responsible for determining appropriate response letter based on disposition. Assist with internal and external communication related to grievances and appeals. Responsible for initiating the initial data entry into the appropriate tracking systems. Must be knowledgeable of claims system, benefits, and familiar with all lines of business. Participates in identification, problem solving, and improvements in product design, policies and processes affecting Member Rights and Appeals. The Resolution Coordinator is also the forefront of any incoming correspondence to the Appeals unit. This person is responsible for setting the pace of the workflow within the unit.