Responsibilities
- Evaluate and manage appeals submitted by enrolled providers
- Support compliance with regulatory standards through internal audits and resolution of policy-related issues
- Prepare and distribute official correspondence detailing appeal outcomes
- Offer guidance and peer assistance to team members managing difficult appeal scenarios
- Act as a subject matter expert for intricate cases including those involving CA IPA or SIU
- Ensure consistent performance meeting monthly benchmarks for attendance, output, and accuracy
- Deliver training and continuous support to new team members to facilitate onboarding and operational integration
Responsibilities
- Evaluate and manage appeals submitted by enrolled providers
- Support compliance with regulatory standards through internal audits and resolution of policy-related issues
- Prepare and distribute official correspondence detailing appeal outcomes
- Offer guidance and peer assistance to team members managing difficult appeal scenarios
- Act as a subject matter expert for intricate cases including those involving CA IPA or SIU
- Ensure consistent performance meeting monthly benchmarks for attendance, output, and accuracy
- Deliver training and continuous support to new team members to facilitate onboarding and operational integration
Other
- Expected weekly working hours: 40
- Employment type: Full time
- Application deadline: 01/30/2026
- Candidates with arrest or conviction records will be evaluated in compliance with applicable federal, state, and local laws
