Appeals Coordinator, Geisinger Health Plan (east Coast Resident / Eastern Standard Time)

Geisinger

Pennsylvania, United States
Fully remote
5 years relevant experience
High school diploma or ged
Regulatory compliance knowledge
Geisinger is seeking an Appeals Coordinator to work remotely in Pennsylvania, focusing on managing the Appeals and Grievance process for health plan members. The role entails liaising between members and the plan, ensuring compliance with regulatory standards, and maintaining accurate documentation

Job Summary

  • The role serves as a liaison between members and the plan regarding denied claims, referrals, and quality of care concerns.
  • Candidates must ensure all complaint and appeal timeframes are met according to regulations from DOL, DOH, DOI, NCQA, and CMS.
  • Geisinger offers healthcare benefits including vision, dental, and domestic partners starting from day one.

Matching Summary

Match Score: 85

Geisinger is seeking an Appeals Coordinator to work remotely in Pennsylvania, focusing on managing the Appeals and Grievance process for health plan members. The role entails liaising between members and the plan, ensuring compliance with regulatory standards, and maintaining accurate documentation.

Skills & Requirements

Must-have

  • 5 years relevant experience
  • High School Diploma or GED
  • Regulatory compliance knowledge
  • Appeals and grievances administration
  • Direct member communication

Nice-to-have

  • Strong multitasking abilities
  • Independent work style
  • Excellent communication skills
  • Collaborative team environment
  • Commitment to excellence

Key Requirements

  • Minimum 5 years relevant experience
  • High School Diploma or Equivalent (GED)
  • Ability to travel is required

Work Rights

Not specified

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