Employer Industry: Healthcare Services

Why consider this job opportunity:
- Salary up to $83,028
- Comprehensive benefits package, including 401k contribution programs
- Opportunity for career advancement and growth within the organization
- Flexibility to work remotely from the greater Baltimore metropolitan area
- Engaging work environment with opportunities to mentor and train others

What to Expect (Job Responsibilities):
- Conduct independent research on contractual benefits, limitations, and exclusions for appeals
- Analyze and perform data entry for complex appeals, ensuring timely processing
- Communicate with internal and external stakeholders while maintaining confidentiality
- Mentor and train entry-level associates in appeals management processes
- Participate in monthly meetings to discuss quality improvements and problem-solving strategies

What is Required (Qualifications):
- High School Diploma or GED
- Minimum of 5 years of experience in managed care, healthcare, or insurance payor environments
- At least 2 years of experience in Appeals Management
- Strong research and problem-solving skills
- Excellent organizational and analytical abilities

How to Stand Out (Preferred Qualifications):
- College degree is a plus
- Familiarity with healthcare systems and claims processes
- Experience in member/provider service or utilization management
- Managed care experience

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