Appeals Coordinator

Your Future is our Future At Lumeris , we believe that our greatest achievements are made possible by the talent and commitment of our team members. That's why we are actively seeking talented and collaborative individuals who are passionate about making a difference in the healthcare industry. Join us today as we strive to create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact. We're excited to consider every qualified candidate authorized to work in the United States, although we are unable to sponsor visas for this role at this time. Position: Appeals Coordinator Position Summary: Responsible for reviewing, researching, and resolving appeals. Escalates complex appeals as needed. Ensures compliance with all applicable regulations, standards, timelines, policies, and guidelines. Job Description: Primary Responsibilities Reviews, evaluates, documents, and tracks appeal documents. Follows request through resolution by established processes and procedures, and within established time standards. Creates, composes, and provides quality written responses (applying the appropriate composition, grammar, punctuation, and spelling) to appeals request within established time standards. Helps identify areas of improvement for self and the department. Prepares case files for Independent Review Entities or other levels of the Appeals process. Communicates with members and providers on ap