Job Description

Overview

The Care Coordinator - Appeals is responsible for supporting health plan, physicians and member requests related to appeals, and scheduling peer to peer conversations. You will be responsible for tracking and monitoring turnaround times to assure service requirements are met. Participation in the collection and documentation of all required data to meet the requirements of the client. 

Schedule after training: Monday - Friday, 9:00a - 5:30p EST

Responsibilities

  • Provide focused resolution, support, and information to customers by embracing CareCentrix Values.
  • Manage cases and requests for services in a timely and accurate manner; collection, verification, and confirmation of non-clinical information and issue escalation.
  • Negotiate with providers when needed and stay within the URAC guidelines.

    • Qualifications

  • High School Diploma or the equival...

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