Remote Mainframe Jobs in Kentucky (NOW HIRING)

Schedule: Days: M-F

Job Location Type: [Remote]

Your experience matters 

At Lifepoint Health, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities. As a member of the Health Support Center (HSC) team, you'll support those that are in our facilities who are interfacing and providing care to our patients and community members to positively impact our mission of making communities healthier .

More about our team 

The Appeals Coordinator gathers all information required for an appeal, writes, and submits the appeal to the insurance company, makes follow-up phone calls, and maintains documentation of all steps taken. The Appeals Coordinator clinical criteria guidelines and clinical documentation to develop sound and well-supported appeal arguments to support medical necessity. The Appeals Coordinator works independently and collaboratively with other departments to positively affect clinical and financial outcomes. 

How you'll contribute 

A Appeals Coordinator who excels in this role:

• Display knowledge of clinical pertinence and managed care requirements to support medical necessity criteria for inpatient and outpatient levels of care.

• Verify the information needed by the insurance plan for an appeal, where to submit the appeal, and method of submitting appeal.

• Manage large volumes of documents including copying, faxing and scanning incoming mail.

• Document and logs information on tracking systems and mainframe systems.

• Ensure appeals are completed thoroughly and on a timely basis.

• Interface with managed care organizations, external reviews, and other payers.

• Obtain access to various provider portals and utilize portals for submitting appeals and following up on status of appeals when applicable.

• Communicate with facility UR staff when needed to efficiently complete the appeal process.                                                                   

Why join us 

We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers: 

• Comprehensive Benefits: Multiple levels of medical, dental and vision coverage for full-time and part-time employees.

• Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.

• Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.

• Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).

• Professional Development: Ongoing learning and career advancement opportunities.

What we're looking for 
Applicants should have a Bachelor's Degree in social work, RN or degree in a related behavioral health field and minimum of 2 years of experience in a managed care/healthcare setting. Additional requirements include:

• Previous utilization review experience in a psychiatric healthcare facility preferred

• Computer proficiency in Microsoft Office applications and other software programs essential to perform job functions

• May be required to work flexible hours and overtime
   

EEOC Statement

"Lifepoint Health is an Equal Opportunity Employer. Lifepoint Health is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment."

You must be authorized to work in the United States without employer sponsorship.

Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers and team members we serve.