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Healthcare Appeals Associate

April, 22

  • usaMexico
  • usaFull-time
  • usaHealth
  • usaRemote
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Overview: - Join a health technology startup focused on transforming healthcare through payer-provider collaboration. - Healthcare Appeals Associate role to scale efforts in insurance advocacy. Key Responsibilities: - Draft insurance appeals using legal, clinical, and technical vocabulary. - Research medical studies, insurance contracts, and coverage guidelines. - Interpret health insurance policies and apply knowledge of covered benefits. - Utilize AI tools to accelerate drafting and increase effectiveness. - Verify authorization statuses and maintain CRM case records. - Guide patients through the appeal process with clarity and empathy. - Advocate for patients, potentially impacting life-changing surgeries. - Create SOPs, templates, and internal documentation for appeals and workflows. Requirements/Skills/Qualifications: - Bachelor’s degree in law, public health, medicine, biology, journalism, or policy. - Experience in health insurance appeals, medical-legal research, patient advocacy, utilization management, or case review. - Proficiency with CPT/ICD-10 codes, AI writing tools, CRM platforms, and medical documentation. - Strong writing skills to explain complex ideas clearly and persuasively. - Curiosity in clinical literature and payer rules. - Empathy and a drive to change lives. - Detail-oriented with the ability to manage multiple cases and deadlines. - Comfortable working remotely and using digital tools. Compensation & Benefits: - Competitive salary for a full-time, long-term position. - Work from home with a standard work schedule (Monday through Friday, 8 am to 5 pm PST). - Additional perks not specified in the description. - Independent contractor agreement with TLNT required.
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TLNT & Spin Hire

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