UM Appeals Processing Assistant (Hybrid Option)

• Annual incentive bonus plan
• Medical, dental, and vision insurance with low deductible/low cost health plan
• Generous vacation and sick time accrual
• 12 paid holidays
• State Retirement (pension plan)
• 401(k) Plan with employer match
• Company paid life and disability insurance
• Wellness Programs
• Public Service Loan Forgiveness Qualifying Employer

Primary Purpose of Position: This position provides administrative and office/procedural support work for the Appeals unit by relieving the department of routine office tasks. This position will also provide departmental support by creating, maintaining, and/or distributing appeals, reports, spreadsheets and databases.

Role and Responsibilities:

90%: Administrative Departmental Activity Support:

• Provide administrative support to the Appeal department including but not limited to copying, filing, mailing, meeting coordination and other administrative duties as needed.
• Processing Reconsiderations/Appeals that come into the department and adhere to Appeal timeframes.
• The Administrative Support will create and track Appeal information.
• Provides rotating back up support for the front desk Administrative Assistant.
• Provide assistance to the Appeals process by assembling Appeal folders for UM Supervisors/ Appeal Clinicians.
• Coordination/scheduling of Mediation/Formal Hearing schedule; Recording/documenting Mediation Summary.
• Tracking Notice of Decision letters and necessary outcomes in spreadsheets.
• Maintains filing system for all Appeal files
• Mails acknowledgement letters of receipt.
• Participates in telephone workgroup rotation and assist with telephone calls.
• Screens and routes mail for Appeals department and maintains returned letters log.
• Ensures that data is thoroughly and accurately entered and maintained in all applicable systems and/or databases as per established practices, processes, or protocols.
• Appropriately directs questions/concerns and promotes a positive work environment.

10% Other: Complete other supportive duties as assigned by supervisor.

Knowledge, Skills and Abilities:

• Considerable knowledge of office techniques and technology
• Basic recognition and knowledge of medical terminology.
• Excellent computer skills and proficient in Microsoft office (Word, Excel, Outlook)
• Ability to communicate effectively both orally and in writing
• Ability to gather information and produce reports
• Ability to establish and maintain effective interpersonal relationships
• Ability to analyze and interpret policy and procedural guidelines
• Ability to organize workflow and coordinate activities
• Ability to effectively problem-solve
• Ability to manage and uphold integrity and confidentiality of sensitive data

Education/Experience Required: High School graduate or equivalent and two (2) years of administrative support experience in a healthcare or behavioral healthcare setting; or an equivalent combination of training and experience.

Education and Experience Preferred: Previous experience working with protected health information preferred but not required.

Licensure/Certification Requirements: N/A