Remote Claims Appeals Specialist

Imagine360; United States; A distancia; USD 45.000 - 65.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Multiple Health Plan Options

Company paid employee premiums for dis

Life Insurance

Parental Leave Policy

20 days PTO to start / 10 Paid Holiday

Tuition reimbursement

401k Company contribution

Professional development initiatives

Diversity & inclusion initiatives

Descripción de la vacante

Imagine360 is seeking an Appeals Review Specialist to join our remote team. The role focuses on reviewing claims for errors, addressing provider inquiries, and generating denial explanations while maintaining strict confidentiality.

Responsibilities include researching questions, training staff, and contributing to quality improvement efforts to protect plan assets and ensure compliance with plan documents.

Formación

• Proficient in office software and data entry accuracy.
• Experience reviewing healthcare claims and supporting denials/appeals.
• Ability to maintain confidentiality and follow regulatory guidelines.

Responsabilidades

• Review claims for accuracy against medical records.
• Respond to member/provider inquiries in writing or by phone.
• Provide denial explanations and escalation as needed.
• Support training and quality improvement initiatives.

Conocimientos

Microsoft Office

10-key typing

Attention to detail

Communication skills

Confidentiality

Educación

High school diploma or equivalent

Minimum of two years healthcare claims experience

Herramientas

Microsoft Office

Descripción del empleo

Imagine360 is seeking an Appeals Review Specialist to join our remote team. The role focuses on reviewing claims for errors, addressing provider inquiries, and generating denial explanations while maintaining strict confidentiality.

Responsibilities include researching questions, training staff, and contributing to quality improvement efforts to protect plan assets and ensure compliance with plan documents.