Job Details

A company is looking for a UM Appeals Analyst - MAC.Key ResponsibilitiesReview service requests for completeness and manage initial screening for UM Appeals requestsPrepare and present cases for the Member Appeals Committee and facilitate communication among involved partiesMentor junior staff and assist in developing training for proper appeal handlingRequired QualificationsHigh School Diploma/GED requiredMinimum of 5 years healthcare industry or operations experienceMinimum of 3 years direct customer service experience, preferably in a medical support rolePreferred experience with prior appeals handling and correspondenceKnowledge of medical terminology and Managed Care principles preferred