CLINICAL APPEALS - LVN Kelly Services has an exciting opportunity for a Clinical Appeals - LVN to come work with our client located in Houston, TX. ROLES AND RESPONSIBILITIES
Sends out written communication to members and/or providers within CMS Appeals and Grievance and appeals time frames.
Communicates with organizations (regulatory agencies, contracted providers, etc.) and members to request and submit information as appropriate.
Maintains current knowledge of Appeals and Grievance requirements and changes required by CMS.
Complete accurate Appeals and Grievances cases as required by CMS within regulatory timeframes.
Facilitates the resolution of member/provider problems while acting in accordance with plan policies and guidelines.
Actively demonstrates excellent customer service to both external and internal customers
Current/active Texas LPN License
Computer literate. This includes simultaneous use of multiple programs and applications.
HOW TO APPLY This position is recruited for by a remote Kelly office, not your local Kelly branch. To apply for this opportunity please utilize the “Apply Now/Submit Resume” button. Every day, Kelly Healthcare Resources (KHR) specializes in providing highly skilled nursing and allied health professionals within hospitals and other health care facilities, as well as positions in sectors such as insurance, pharmaceutical, health management and education. Related Search Terms: Appeals, Appeals Specialist, LVN Nurse Appeals Specialist, Chart Reviewer, Chart Abstraction, clinical appeals#LI-KS262
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