Harris Health System

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Appeals Coordinator (CHC)

at Harris Health System

Posted: 9/20/2019
Job Status: Full Time
Job Reference #: 147494
Keywords: data entry

Job Description

About Us

Community Health Choice, Inc. (Community) is a non-profit Health Maintenance Organization (HMO) licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 70 hospitals, Community serves over 260,000 Members with the following programs:

• Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

• Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

• Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Job Profile

The Appeals Coordinator is a appeals and data management position within Community Health Choice, HMO with responsibilities including, but not limited to: a) data entry of provider appeals and inquiries; b) accurate recording of all provider data elements into database c) effective follow-up of provider appeals and inquiries to ensure closure within 30 days of receipt d) verification of receipt and handling of all certified mail; e) preparation of documents for laserfiche and scanning and f) sort and distribution of all incoming mail.

Qualifications:

  • HS Diploma or GED
  • Two years insurance related job experience &/or moderate to advanced computer knowledge. Medical terminology or medical assistant experience preferred, but not required.

OTHER SKILLS:

  • Microsoft Word/Excel experience preferred.
  • Exceptional Writing and Grammar, Writing /Composing (Correspondence / Reports)
  • Analytical


Benefits and EEOC

Community employees’ benefits are provided by Harris Health. These benefits are designed to provide you with flexibility and choices in meeting your specific needs.

Community is an Equal Opportunity Employer.

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Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!