Community Health Options
51 - 200 employees
Founded 2012
⚕️ Healthcare Insurance
Healthcare Insurance • Insurance
Community Health Options is a Maine-based health insurance provider dedicated to offering flexible and affordable health plans for individuals and families, as well as small and large groups. They focus on providing comprehensive healthcare coverage with a wide network of in-network providers, while also offering wellness programs, virtual care options, and specialized support for chronic illnesses. Their mission centers around delivering benefits designed to meet the real needs of their members, while helping to reduce out-of-pocket healthcare costs.
Third Party Liability & Appeals Specialist
🔥 0 minutes ago
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Community Health Options
51 - 200 employees
Founded 2012
⚕️ Healthcare Insurance
Healthcare Insurance • Insurance
Community Health Options is a Maine-based health insurance provider dedicated to offering flexible and affordable health plans for individuals and families, as well as small and large groups. They focus on providing comprehensive healthcare coverage with a wide network of in-network providers, while also offering wellness programs, virtual care options, and specialized support for chronic illnesses. Their mission centers around delivering benefits designed to meet the real needs of their members, while helping to reduce out-of-pocket healthcare costs.
📋 Description
• Maintain subject matter expertise for all lines of business (LOB) • Support Manager in writing/reviewing Appeal letter language • Process appeals in accordance with established standards and workflow • Generate reports, monitor and address trends within appeals and reconsiderations
🎯 Requirements
• Bachelor's Degree in healthcare or related field, preferred • Health Plan appeal experience, preferred • 8+ years of experience in claims, insurance, or TPL recovery; workers compensation, coordination of benefits, and subrogation • Certification Revenue Cycle Representative (CRCR), a plus
🏖️ Benefits
• Health insurance • Flexible work arrangements • Professional development
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