Posted 2w ago

UM Appeals Processing Assistant (Hybrid Option)

@ Partners Health Management
Gastonia, North Carolina, United States
HybridFull Time
Responsibilities:Coordinate scheduling, Process appeals, Maintain files
Requirements Summary:High school diploma or equivalent; two years admin support experience in healthcare; proficient in Microsoft Office; strong communication and data entry; maintains confidentiality.
Technical Tools Mentioned:Microsoft Office, Data entry, Spreadsheet tools
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Job Description
Competitive Compensation & Benefits Package!  

Position eligible for – 

  • Annual incentive bonus plan
  • Medical, dental, and vision insurance with low deductible/low cost health plan
  • Generous vacation and sick time accrual
  • 12 paid holidays
  • State Retirement (pension plan)
  • 401(k) Plan with employer match
  • Company paid life and disability insurance
  • Wellness Programs
  • Public Service Loan Forgiveness Qualifying Employer

See attachment for additional details. 

 

Office Location:  Available for Gastonia, NC; Hybrid position (required to come into the office 2 days per week)

Projected Hiring Range:  Depending on Experience

Closing Date: Open Until Filled



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.  

 

Role and Responsibilities:  

90%: Administrative Departmental Activity Support:  

  • 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.  

10% Other: Complete other supportive duties as assigned by supervisor.  

 

Knowledge, Skills and Abilities:  

  • 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

 

Education/Experience Required: 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.  

Education and Experience Preferred: Previous experience working with protected health information preferred but not required. 

Licensure/Certification Requirements: N/A