Full-Time Appeals Support Representative
Discovery Behavioral Health is hiring a remote Full-Time Appeals Support Representative. The career level for this job opening is Entry Level and is accepting Irvine, CA based applicants remotely. Read complete job description before applying.
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Discovery Behavioral Health
Job Title
Appeals Support Representative
Posted
Career Level
Full-Time
Career Level
Entry Level
Locations Accepted
Irvine, CA
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Job Details
The Appeals Support Representative role supports the Clinical Appeals Specialist in the administrative functions of Denials and Appeals within the Utilization Review Team.
Responsibilities:
- Complete outbound calls to payers for status updates.
- Interact with third party insurance representatives and utilize online sites to review status.
- Track and confirm weekly status updates on all outstanding appeal cases.
- Request, track, and receive payer correspondence regarding approvals and denials.
- Organize and scan all payer determination letters in KIPU charting system and update the Clinical Appeals Specialist within 24 hours of receipt.
- Document final appeal outcomes as well as case details in KIPU chart system and appeal spreadsheet.
- Responsible for obtaining patient and/or guardian signatures on required payer consent forms.
- Submit retro authorization requests, provide support for retro SCA projects, and follow up on retro auth submissions until final resolution.
- Identify problem cases and escalate issues to Clinical Appeals Specialist as appropriate.
- Attend and participate in all monthly UR Team meetings and all quarterly Denials meetings.
- Adhere to privacy and HIPAA guidelines.
- Perform and/or assist with special projects as assigned.
Requirements:
- Associate’s degree required or High School Diploma plus 5-7 years of appeals and grievance experience; Bachelor’s degree preferred.
- Ability to work Monday through Friday, 8:00am-4:30pm or 8:30am-5:00pm EST.
- Ability to utilize and navigate Zoom and Microsoft Teams for remote meetings and IM chat.
- Strong Microsoft Office skills (Excel, Word, Outlook)
- Experience with insurance follow up and/or appeals and grievances required.
- Familiarity with medical billing, provider relations, and/or healthcare office experience required.
- Ideal candidate must be a self-starter with strong attention to detail, the ability to multi-task, a high level of organization, and excellent communication skills.
- Ability to remain flexible and adapt to changing situations.
- Excellent customer service skills and strong analytical skills.
FAQs
What is the last date for applying to the job?
The deadline to apply for Full-Time Appeals Support Representative at Discovery Behavioral Health is
21st of August 2025
. We consider jobs older than one month to have expired.
Which countries are accepted for this remote job?
This job accepts [
Irvine, CA
] applicants. .
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