Claims Appeal Coordinator - La Palma, CA(Job Number:706436)
AppleCare Medical Management Group. The multispecialty medical group of independent practices has expanded into new communities, contracted with more hospitals and health plans, and added over 50 new doctors - but the mission has remained the same. Today, AppleCare Medical Management is comprised of hundreds of board-certified private-practice, independent physicians. Collectively, our physicians have been serving the Southeast area of Los Angeles and Northern Orange County for decades, providing their medical expertise and passion to improving the health of our communities.
Responsible for researching, responding and resolving claims appeals, provider disputes, and adjustments. Will also be responsible to respond and adjust claims from health plan demands.
Review and process provider disputes and appeals as established in the Claims Department Policies and Procedures
Respond to claims appeals and disputes in a timely manner
Track disputes and adjustments to monitor compliance
Serve as a resource to claims auditing when needed
To contribute to a fair and positive work environment by treating peers, superiors, subordinates, clients and vendor with professionalism and respect
Perform other duties as directed
Job Claims Appeals
Primary Location US-CA-LA PALMA
Number of Openings 1