Appeals Specialist (Medical Claims)

Mountlake Terraceonsitemid$64K$86K

via Greenhouse

About this role

Do you enjoy working with a great team of people? Do you provide exceptional service even when having to solve issues that may be complex and difficult? Does the phrase “details matter” describe your approach to everything? If you answered “YES” then you may be the person we’re seeking for our Appeals Specialist position! What you'll be doing... The Appeals Specialist will assist in the operations of the Health and Welfare Claims Department and will primarily focus on member disputes and appeals. Review and process member and provider appeals, ensuring accuracy and adherence to policies Analyze claims, benefits, contracts and regulations to make informed appeal decisions Collaborate with internal teams to prepare and present appeal cases for resolution…

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What we'd score you on

reqspace match rubric

Five dimensions, recruiter-grade. Upload your resume and we'll generate a written explanation of where you fit and where the gaps are.

1

Skills match

For this role: teams

2

Level fit

This role is mid-level. We check your trajectory against it.

3

Domain experience

Your work in the role's domain matters more than your years total. We weight recent and direct experience.

4

Recency

A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.

5

Location fit

This role is based in Mountlake Terrace. We weight your proximity and willingness to relocate.

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