Appeals Specialist
About The Position
The Appeals Specialist will be the friendly expert guiding members and providers through the appeals process. This role involves setting up cases, coordinating reviews, sending important communications, and ensuring the process runs smoothly and on time. The Appeals Specialist will collaborate with clinical reviewers, Independent Review Organizations, and the Wyoming Department of Insurance. This position requires a detail-oriented, tech-savvy individual who thrives in a fast-paced environment where accuracy matters. The ideal candidate will bring adaptability, integrity, and a member-first mindset.
Requirements
- Detail-oriented.
- Tech-savvy.
- Ability to thrive in a fast-paced environment where accuracy matters.
- Adaptability.
- Integrity.
- Member-first mindset.
- Confirmation of Wyoming residency, intent to become a Wyoming resident, or reasonable commuter distance if Colorado resident.
Responsibilities
- Setting up cases for appeals.
- Coordinating reviews for appeals.
- Sending important communications related to appeals.
- Ensuring the appeals process runs smoothly and on time.
- Collaborating with clinical reviewers, Independent Review Organizations, and the Wyoming Department of Insurance.
Benefits
- Best-In-Class Health Insurance at minimal to no-cost for BCBSWY employees.
- Highly competitive compensation.
- Annual compensation program review for competitive market match.
- Eligibility for annual merit increases.
- Monthly incentives based on individual and company performance.
- Generous performance-based commissions for Sales Team members.
- Medical insurance.
- Dental insurance.
- Vision insurance.
- 401(k).
- Life insurance.
- Paid time off (PTO).
- 10 paid holidays in addition to PTO annually.
- 8 paid volunteer hours.
- Various wellness programs.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
