Appeals Specialist II

Title: Appeals Specialist II

Job Description:

locations

OK - Tulsa

time type

Full time

job requisition id

R0046919

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

Under Supervision, This Position Is Responsible For Processing And Adjudicating Complex Non-Utilization. Management Appeals According To The Appropriate Federal, State, And Ncqa Requirements And Regulations; And Responding, By Phone, In Person, Or In Writing, To All Inquiries Involving Member*S Requests For Appeals. May Train And Mentor Less Experienced Appeals Specialists.

***THIS IS NOT A FULLY REMOTE POSITION. THIS IS A HYBRID POSITION. YOU WILL BE EXPECTED TO COME INTO OFFICE 2 WEEKS PER MONTH AND WILL WORK REMOTELY 2 WEEKS PER MONTH. OUR OFFICE LOCATION IS 1400 S BOSTON AVE, TULSA, OK 74119.***

 

The anticipated starting pay for this role is $22.50-$25.00/hr non-negotiable.

 

JOB REQUIREMENTS:
* High School Degree or GED.
* 3 years’ experience in a customer service role OR in a health insurance or medical environment.
* Knowledge of medical terminology to include coding.
* Experience and skills to analyze and assist customer based on knowledge of federal, state, and NCQA guidelines.
* Experience and skills to organize tasks and accommodate large volume of reference materials.
* Experience and skills to understand fine details of customer complaint issues.
* Verbal and written communication skills.


PREFERRED JOB REQUIREMENTS:
* Blue Chip claims payment experience.
* 2-year experience processing claims and utilizing a claims payment system.
* Bilingual English/Spanish.

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Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. 

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range

$18.10 - $37.10

Exact compensation may vary based on skills, experience, and location.