Appeals Specialist II

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🔥 0 minutes ago

🚗 Michigan – Remote

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💵 $20 - $34 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

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Logo of Centene Corporation

Centene Corporation

10,000+ employees

Founded 1984

⚕️ Healthcare Insurance

🤝 Non-profit

🌍 Social Impact

Healthcare Insurance • Non-profit • Social Impact

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Supports the documentation and processing of appeals, disputes and reconsiderations • Ensures they are in accordance with state and NCQA requirements • Performs data entry to support the tracking, logging, and processing of appeals • Prepares correspondence for appeals, disputes and reconsiderations • Maintains documentation files and reviews requests • Conducts research needed to evaluate, process, and respond to appeals

🎯 Requirements

• High School diploma or GED • 1 – 2 years of related experience • Knowledge of appeals, disputes and reconsiderations process preferred

🏖️ Benefits

• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules

Apply Now

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