Meridian Illinois Hiring for Denial Coordinator – Remote at Apple River, IL Full Time

Position Purpose:

Generate and process denial letters and Notice of Action (NOA) for pre services, leveling of care and denied medical services.

• Maintain the denial and/or appeals logs and assessments in accordance with associated guidelines
• Responsible for the Medical Management denial process including letter printing, tracking and disposition of letters within contractual guidelines to ensure compliance
• Serve as the department liaison for all denial and/or appeals issues
• Train others on denial and/or appeals work processes
• Prepare monthly, quarterly, and annual reports for denials and/or appeals
• Review log to ensure compliance with the denial process and turn-around timeframe (TAT) for all denial and/or appeals notifications

  
  Education/Experience:

  High school diploma or equivalent. Associate’s degree preferred. 2+ years of related managed care experience and medical terminology.

  Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.