Appeals Coordinator Optima Health 44 reviews - Virginia Beach, VA 23462
Responsible for the investigation and documentation of member appeals
and grievances in compliance with State law, applicable rules and
regulations and provider and group agreements. Works closely with the
Plan's Medical Directors who are responsible for all decision regarding
clinical appeals/ grievances and the Appeals Manager who is responsible
for non-clinical appeals and grievances. Physical Location Optima Health
- Va Bch Department Number and Name 706002369 SHP - Appeals/Complaints
Employment Status Full time Shifts First (Days) Job Posting Optima
Health is hiring an Appeals Coordinator to join our team in Virginia
Beach, VA. Hours/Shift: Monday - Friday, Day shift, 40 hours/wk.
Department/Position Overview: We are seeking an experienced,
professional Appeals Coordinator to help support our Optima leadership
and our efforts to fulfill our mission on a daily basis. Professional,
well-balanced, self-directing yet a collaborative team player with an
unsurpassed administrative talent and keen sense of proactivity to drive
a positive work environment are ideal. Additional key qualities include
but are not limited to: multitasking, attention to detail, effective
communication, and strong organizational skills to maintain multiple
calendars from multiple leaders. Ability to sit for long periods of time
performing job functions and strong Microsoft Office experience is a
must. Required experience: Managed Care - 3 years Division Highlights:
Optima Health offers a full suite of commercial health insurance
products including employee-owned and employer-sponsored plans, as well
as Individual and Family health plans, employee assistance plans and
plans serving Medicare and Medicaid enrollees. We offer programs to
support members with chronic illnesses, customized wellness programs,
and integrated clinical and behavioral health services. As a nationally
recognized provider of health plan coverage and innovative wellness
programs, we live our mission "to improve health everyday." This same
commitment and dedication directs our philosophy as an employer. When
you join Optima Health, you will experience our deep passion for heal
and service excellence while benefiting from a culture of opportunity,
learning, career growth, and support -every day. Optima Health is a
service of Sentara Healthcare, so joining Optima is joining the Sentara
Healthcare family. Sentara Benefits: Sentara employees strive to make
our communities healthier places to live. Were setting the standard for
medical excellence within a vibrant, creative, and highly productive
workplace. For more information about our employee benefits, CLICK HERE!
Join our team, where we are committed to quality healthcare, improving
health every day, and provide the opportunity for training, development,
growth! Required Education High School Grad or Equivalent Experience
Required: Managed Care - 3 years Licenses and Certifications Provider
Appeal Coordinator positions require CPC Certification within 1 year of
eligibility. Skills Required: Microsoft Access, Microsoft Excel,
Microsoft Word City Virginia Beach, VA 2 hours ago - save job - original
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Jobs at Optima Health in Virginia Beach, VA * Appeal Coordinator
salaries in Virginia Beach, VA Optima Health Optima Health 44 reviews
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