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Location:
Remote work but the first week may be in-office for training.
Job Description:
- Gathers all information required for an appeal, writes, and submits the appeal to the insurance company, makes follow up phone calls, and maintains documentation.
- Utilizes criteria guidelines and clinical documentation to develop sound and well-supported appeal arguments to support medical necessity.
- Works independently and collaboratively with other departments to positively affect clinical and financial outcomes.
Education:
- Requires a Bachelor’s degree in Social Work, RN or degree in a related behavioral health field.
- 2+ years of experience in a managed care/healthcare setting; or any combination of education and experience
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