UM Appeals Processing Assistant (Hybrid Option)

Partners Behavioral Health Management•Gastonia, NC

2d•Hybrid

About The Position

Primary Purpose of Position: This position provides administrative and office/procedural support work for the Appeals unit by relieving the department of routine office tasks. This position will also provide departmental support by creating, maintaining, and/or distributing appeals, reports, spreadsheets and databases.

Requirements

Considerable knowledge of office techniques and technology
Basic recognition and knowledge of medical terminology.
Excellent computer skills and proficient in Microsoft office (Word, Excel, Outlook)
Ability to communicate effectively both orally and in writing
Ability to gather information and produce reports
Ability to establish and maintain effective interpersonal relationships
Ability to analyze and interpret policy and procedural guidelines
Ability to organize workflow and coordinate activities
Ability to effectively problem-solve
Ability to manage and uphold integrity and confidentiality of sensitive data
High School graduate or equivalent and two (2) years of administrative support experience in a healthcare or behavioral healthcare setting; or an equivalent combination of training and experience.

Nice To Haves

Previous experience working with protected health information preferred but not required.

Responsibilities

Provide administrative support to the Appeal department including but not limited to copying, filing, mailing, meeting coordination and other administrative duties as needed.
Processing Reconsiderations/Appeals that come into the department and adhere to Appeal timeframes.
The Administrative Support will create and track Appeal information.
Provides rotating back up support for the front desk Administrative Assistant.
Provide assistance to the Appeals process by assembling Appeal folders for UM Supervisors/ Appeal Clinicians.
Coordination/scheduling of Mediation/Formal Hearing schedule; Recording/documenting Mediation Summary.
Tracking Notice of Decision letters and necessary outcomes in spreadsheets.
Maintains filing system for all Appeal files
Mails acknowledgement letters of receipt.
Participates in telephone workgroup rotation and assist with telephone calls.
Screens and routes mail for Appeals department and maintains returned letters log.
Ensures that data is thoroughly and accurately entered and maintained in all applicable systems and/or databases as per established practices, processes, or protocols.
Appropriately directs questions/concerns and promotes a positive work environment.
Complete other supportive duties as assigned by supervisor.