Appeals Coordinator

Memorial Physician Practices; Louisville (KY); Remote; USD 45,000 - 75,000; Full time

Job summary

An established industry player in behavioral health services is seeking a dedicated Appeals Coordinator to join their remote team. This role is crucial for ensuring that appeals are effectively managed, requiring strong analytical and communication skills. The ideal candidate will gather necessary information, craft compelling appeal arguments, and collaborate with various departments to enhance clinical and financial outcomes. With a commitment to compassionate care and superior patient service, this organization offers a supportive environment where your contributions will directly impact the quality of healthcare provided. If you are passionate about making a difference in the lives of others, this opportunity is for you.

Benefits

Competitive Pay Rates

Flexible Self-Scheduling

Affordable Medical, Dental, and Vision Plans

Up to 16 Days PTO

6 Paid Holidays

Tuition Reimbursement

401(k) Retirement Plan

Flexible Spending and Health Savings Accounts

UKG Wallet - Earned Wage Access

Qualifications

• Bachelor’s degree in social work or related field required.
• 2+ years of experience in managed care/healthcare setting.

Responsibilities

• Gather and submit appeal information to insurance companies.
• Develop sound appeal arguments using clinical criteria.

Skills

Clinical Documentation

Communication Skills

Analytical Skills

Problem-Solving

Education

Bachelor’s Degree in Social Work

RN Degree

Degree in Related Behavioral Health Field

Tools

Microsoft Office

Job description

Appeals Coordinator - Remote

Full-time

At Lifepoint Behavioral Health, we specialize in compassionate behavioral health services, including crisis stabilization for acute mental health and substance use disorders. Our philosophy is built on a psychosocial model of care and follows the core principles of resilience, recovery, and restoration. Our teams are committed to providing superior patient care that exceeds industry standards as well as patient expectations. We are seeking a full-time Appeals Coordinator to be based 100% remotely.

Benefits:

• Competitive pay rates
• Flexible self-scheduling
• Affordable medical, dental, and vision plans provided to meet the needs of full employees and their families
• Up to 16 days of PTO for full-time employees
• 6 paid holidays for full-time employees
• Tuition reimbursement
• 401(k) retirement plan
• Flexible spending and health savings accounts
• UKG Wallet - We've partnered with UKG Wallet, a voluntary Earned Wage Access benefit, to offer employees access to their pay on their own schedule

What you will do in this role:

• 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 applies 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.

Qualifications:

• Requires Bachelor’s Degree in social work, RN, or degree in a related behavioral health field and a minimum of 2 years of experience in a managed care/healthcare setting; or any combination of education and experience, which would provide an equivalent background.
• 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.