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Samford University McWhorter School of Pharmacy

Birmingham, Alabama

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Northeast Georgia Health System

Gainesville, Georgia

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Northeast Georgia Health System

Gainesville, Georgia

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Labcorp

Houston, Texas

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CommonSpirit Health Mountain Region

Colorado Springs, Colorado

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Vanderbilt Health

Nashville, Tennessee

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Northeast Georgia Health System

Gainesville, Georgia

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Northeast Georgia Health System

Braselton, Georgia

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Veterans Affairs, Veterans Health Administration

Brookings, Oregon, Oregon

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Vanderbilt Health

Nashville, Tennessee

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Clinical Appeals Specialist - TLRA Revenue Cycle
DescriptionSummary:This position requires the ability to work independently researching and reviewing inquiries from members and providers. Also requires knowledge of benefit interpretation, claims reviews, CPT and ICD coding. Responsible for analyzing, researching, and managing appeal/grievance inventories from members and providers. Respond to inquiries using verbal and written forms of communication.Responsibilities: Research and provide resolution to issues such as claim denials, member and provider complaints, and reconsideration and redetermination requestsReview and respond to complaints, grievances and appeals within the stated time frame for each requestEnsure 95% compliance with the Ce


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