Appeals Specialist

🔥 17 hours ago

🇺🇸 United States – Remote

💵 $23 - $30 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Devoted Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2017

🏥 Healthcare

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare • Healthcare Insurance • Wellness

Devoted Health is a healthcare company that offers Medicare Advantage plans designed to provide comprehensive health coverage with added benefits like dental, eyewear, gym memberships, and prescription drugs at competitive rates. The company emphasizes member support and service, ensuring that clients can easily navigate their benefits and access needed healthcare services. Devoted Health is committed to helping customers save money and enhance their health and wellness through a complete package of benefits and support.

📋 Description

• Correspond with members and/or providers through written communication and telephone contact, with appropriate documentation • Coordinate with managers, internal departments, and external vendors to investigate, review, and resolve appeals • Research cases and prepare them for internal or external review • Manage the receipt, investigation, and resolution of appeals in a timely, compliant, and effective manner • Maintain current knowledge of Devoted Health products, policies, and procedures • Explain product, policy, and procedure information clearly to members, providers, and other individuals • Complete data entry and documentation in multiple systems to capture required CMS universe details

🎯 Requirements

• Strong computer, analytical, oral and written communication skills • Bachelor’s degree or equivalent experience in health care, conflict resolution, or related field • Detail oriented; data integrity and documentation are very important • Superior investigation, customer service, interpersonal, and problem-solving skills • Working knowledge of insurance products, policies, procedures, and claims process

🏖️ Benefits

• Employer sponsored health, dental and vision plan with low or no premium • Generous paid time off • $100 monthly mobile or internet stipend • Stock options for all employees • Bonus eligibility for all roles excluding Director and above • Commission eligibility for Sales roles • Parental leave program • 401K program

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