ptcbio · Other · Live in: United States
Posted 2026-11-03 · Verified 2026-11-04
Job Description A bit about this role: The Appeals Specialist is an integral part of our Appeals Operations team & our overarching Provider Escalations & Educations team. The Appeals Specialist is responsible for the timely processing & effective decision making on Appeals received from plan Providers, Non-Contracted Providers, & our Members or their appointed representatives. This individual will work cross functionally with areas such as Clinical, Medical Directors, UM, & claims to ensure we’re making appropriate decisions on our appeal reviews. Your Responsibilities and Impact will include: Correspond with members and/or providers as required (i.e., written communication and telephone... Read the full ad