The Utilization Review and Denials and Appeals Process Coordinator is responsible for all clerical aspects of denials and appeals including, but not limited to, processing requests for concurrent or retro reviews. This individual will be a liaison and point of contact to/for PBS, UM and other CHS representatives for denial and appeal inquiries. This individual must be able to work independently and manage customer service and project workflow

LEVEL OF EDUCATION

Preferred: Associate's or Bachelor's Degree

TECHNICAL REQUIREMENTS

Minimum: Intermediate MS Excel, Word, Outlook, and PowerPoint skill and proficient Internet skills

Preferred: Proficiency with electronic medical records, databases, and clinical application software

YEARS OF RELATED WORK EXPERIENCE

Minimum: 2 years of clerical experience in a healthcare setting

Preferred: Previous experience in denials and appeals, insurance follow up, and patient financial services