Appeals Representative

Apply for this Position

Application Form     (* indicates required field)

Please attach the following files

Please upload either a word or PDF version of your cover letter for this position.
Please upload either a word or PDF version of your current resume.
Such as letters of recommendation, work examples, etc.

Please answer the following questions to help us better evaluate your application.

I hereby authorize the potential employer to contact, obtain, and verify the accuracy of information contained in this application from all previous employers, educational institutions, and references. I also hereby release from liability the potential employer and its representatives for seeking, gathering, and using such information to make employment decisions and all other persons or organizations for providing such information.

I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered.

If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, either I or the employer can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.

I understand that it is the policy of this organization not to refuse to hire or otherwise discriminate against a qualified individual with a disability because of that person’s need for a reasonable accommodation as required by the ADA.

I also understand that if I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment.

I represent and warrant that I have read and fully understand the foregoing, and that I seek employment under these conditions.

You must agree to the disclosure statement provided in order for us to accept your application.

Syndeo Staffing is seeking a qualified Appeals Representative for a temp-to-hire position at a local healthcare company. The hours for this position are Monday - Thursday 8am-5pm and Friday 8am-4pm. 

JOB DESCRIPTION

Summary:

An Appeals Representative will review, research and resolve all types of medical claim appeals from members and providers within stringent timeframes.

Essential Functions:

  • Log each appeal as it is received
  • Prepare acknowledgement and response letters to members and providers
  • Identify, reach, and resolve claim disputes
  • Prepare and submit appeals for Claims Review Committee
  • Review and respond to legal requests
  • Develop and maintain an excellent working knowledge of policies in order to determine eligible benefits and understand how claims were processed or why they were denied
  • Assist providers and members with questions regarding their claims, appeals or policies both in writing and verbally
  • Provide backup coverage for the call center
  • Abide by HIPAA regulations and other privacy policies at all times
  • Maintain an exemplary attendance and tardiness record following established company guidelines
  • Demonstrate ability to work well with other departments and all Medova staff members
  • Complete other tasks, as assigned

Competencies:

  • Technical Capacity
  • Problem Solving
  • Attention to Detail
  • Initiative

Required Education and Experience:

  • High School Diploma or equivalent
  • 1 year professional office experience
  • Knowledge of medical terminology and diagnosis and procedure codes

Preferred Education and Experience:

  • Additional course work in the medical field
  • 2 year health insurance industry knowledge

Computer Skills:

  • Microsoft Outlook
  • Microsoft Word
  • Microsoft Excel
  • Data Entry
  • Ten Key
Location: Wichita, KS
Apply for this Position
Apply at: