Legal Appeals Research Specialist I
| Company | Arkansas Blue Cross |
|---|---|
| Location | Little Rock, AR, USA |
| Salary | $Not Provided – $Not Provided |
| Type | Full-Time |
| Degrees | |
| Experience Level | Mid Level |
Requirements
- High school diploma or equivalent
- Minimum three (3) years’ claims processing, claims research experience, or customer service experience required
- Familiarity with CPT, ICD-10 and Medical Terminology
- Microsoft Office Suite
- ICD 10 and CPT Coding
- Medical Terminology
- Medical Claims Processing
- Researching
- Confidentiality
- Professionalism Judgement
- Interpersonal Communication
- Multitasking
- Highly Organized
- Detail-Oriented
- Problem Solving
- Oral & Written Communication
- Self-Motivated Team Player
- Ability to work independently.
Responsibilities
- Coordinates adjustment activities with adjustments, claims processing area, medical directors, attorneys and professional staff.
- Monitors system queue and provides daily reporting of appeals status.
- Performs other duties as assigned.
- Requests and reviews medical records related to appeals research, as requested.
- Researches complaints utilizing multiple systems and resources.
- Prepares documentation for appeals filing ensuring timely responses.
Preferred Qualifications
-
No preferred qualifications provided.