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Appeals Coordinator/Intake Specialist

Friday Health Plans
Alamosa, CO
  • Expired: July 01, 2022. Applications are no longer accepted.

Who You Are

You are superb at gathering, analyzing, and reporting all information for verbal and written claims and authorization grievances and appeals from providers and members. You work collaboratively and very closely with internal departments to resolve and research appeals in a timely manner. You have strong analytical, writing, and time management skills. You are the Appeals Coordinator/Intake Specialist that we have been looking for!

Who We Are

Friday Health Plans isn't your average health insurance company. We're not about unnecessary extras and confusing terminology. We cover the basic health services you'll likely use the most at a price that just might make your wallet happy. Our simple health plans and friendly service keep you covered so you're free to live every day like it's Friday.

As a Denver-based startup company, we're looking for smart, talented people like you to join us. We value collaboration, innovation, passion, and calculated risk-taking. Now in year seven and growing rapidly, we're looking for people who lead by example, and that example is one of flexibility, reliability, and positivity. If this sounds like you, then we want you on our team.

What You'll Do:

Under the general direction of the Appeals & Grievances Manager, this position has primary responsibility for monitoring & processing all appeal and grievance requests which are received via fax, e-mail, and regular mail.

Essential Duties:

+ Provides initial intake review and determines priority of all appeals, complaints and grievances received by either the Member or Provider

+ Processes all clinical or administrative appeals/grievances according to the appropriate review required for the type of dispute and level of dispute

+ Review appeal documentation submitted to ensure complete information is received prior to forwarding for further review

+ Assist with appeal status calls as well as direction for Members or Providers to file an Appeal/Grievance

+ Complete closure process by saving all appeal documentation and tracking information in the appropriate place

+ Other duties and responsibilities as assigned

Required Knowledge, Skills & Abilities:

+ Detail-oriented

+ Highly organized

+ Ability to prioritize deadlines and make routine decisions

+ Proficient in Excel

+ Ability to utilize a multi-system phone

+ Must be able to work independently and as a team by displaying professionalism in dealing with coworkers, members, and providers

+ Ability to understand and interpret policies and procedures

+ Ability to learn how to utilize multiple computer programs and databases

+ Good oral and written communication skills

+ Must be personable, empathetic, but firm in dealing with members and providers

+ Resourceful in solving problems, researching issues, and communicating with members, providers, and coworkers

Required Education/Experience:

+ High school diploma or GED required

+ Basic knowledge of computers and other office equipment

+ Experience or knowledge of medical systems, billing practices, and health insurance terminology and procedures preferred but not required

How You'll Be Valued

+ Medical, Vision, and Dental premiums for you and your family covered at 100%

+ Company-funded health savings account (HSA)

+ 401(k) and 401(k) matching

+ Company-paid life insurance.

+ Company-paid short- and long-term disability insurance.

+ Employee assistance program

+ Paid time off and 10 paid holidays

+ A company culture that is regularly recognized as a Top Workplace by organizations such as CoBiz and The Denver Post Friday Health Plans is a Top Workplace (https://www.denverpost.com/2021/05/05/top-workplaces-2021-colorado-best-midsized-companies/)

+ Pay: $33,000 - $40,000

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Friday Health Plans

Address

Alamosa, CO
81101 USA

Industry

Legal

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