Behavioral Health Appeals Analyst (IL, TX, OK, NM AND MT) Job Listing at HCSC in Richardson, TX (Job ID R0037394)

Description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

This position is responsible for coordinating processing of Behavioral Health Clinical Appeals by preparing and maintaining records of appeals filings, gathering and reviewing clinical information for communicating the determination of cases, and supporting the Behavioral Health Appeals function.

*THIS IS A FLEX POSITION FOR THE RICHARDSON, ALBUQUERQUE, TULSA, CHICAGO OR HELENA HEADQUARTERS. IT IS NOT A TELECOMMUTER POSITION.
*Needed experience/skills: strong knowledge of excel, experience in Appeals, Utilization Review, Utilization Management, communication, ability to work in multiple systems, and knowledge of State and Federal Department of Insurance guidelines and regulations.

JOB REQUIREMENTS:

• 2 years of college and 3 years' experience coordinating clinical records OR Bachelor's degree and 1 year of experience coordinating clinical records OR 4 years of experience processing managed care/appeals/utilization review.
• Knowledge of medical terminology.
• Knowledge and understanding of State and Federal Department of Insurance and Government guidelines and regulations.
• Written and verbal communication skills.
• Interpersonal skills to interact with internal and external customers, including representative of Department of Insurance and Government Agencies in a rapport-developing manner.
• Organizational skills.
• Detail oriented.
• Analytical skills to review clinical data.
• PC proficiency in Excel and Word. Medical database experience.

PREFERRED JOB REQUIREMENTS:

• Knowledge of Behavioral Health terminology.
• Knowledge of processing Appeals, Denials or Grievances in accordance with regulatory or accreditation requirements
• Knowledge of managed care or behavioral health state and federal regulations.

The Compensation/Salary offered for this Position will vary depending on Job-related skills, education, knowledge and experience. This role aligns with an Annual Incentive Bonus plan.

 

#LI-Hybrid 

Relocation assistance will not be provided for this position.

Sponsorship will not be provided for this position.

We encourage people of all backgrounds and experiences to apply. 

HCSC Employment Statement:

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

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