Appeals Specialist (Medical Claims)
$63,856–$86,403 year
HybridFederal Way, Washington, United States
Federal Way, Washington, United StatesHybridFull Time$63,856–$86,403 yearBachelors DegreeEmployee Benefits AdministrationMedium
Full TimeBachelors DegreeMediumEmployee Benefits Administration
Job Summary
Review and process member and provider appeals, ensuring accuracy and adherence to policies. Analyze claims, benefits, contracts, and regulations to make informed appeal decisions. Collaborate with internal teams to prepare and present appeal cases for resolution, then clearly communicate outcomes to members, providers, and representatives. Provide guidance and support to stakeholders on appeal procedures. This hybrid role includes three days per week in the office, with locations in Seattle, Mountlake Terrace, or Federal Way.
Required Qualifications
- Bachelor's degree or a combination of relevant education and experience
Desired Qualifications
- Medical claims processing and/or appeals experience
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