Senior Appeals Resolution Specialist

hace 1 mes


San Francisco, Heredia, Costa Rica Auxis A tiempo completo
About Auxis

Auxis is a dynamic company that prioritizes employee growth and development, empowering you to advance your career. Our culture fosters collaboration towards common goals, with a focus on continuous improvement.

We offer a comprehensive benefits package, including health insurance, vision, dental, transportation subsidy, Asociacion Solidarista, training programs, recognition incentives, paid time off, family leave, and a birthday day off.

Job Summary

This Senior Appeals Resolution Specialist position plays a crucial role in performing end-to-end tasks for technical appeals. The ideal candidate will have excellent communication skills, ability to work effectively with others, and knowledge of organizational policies and procedures.

Key Responsibilities
  • Triage incoming inventory for the Appeals team, ensuring appeal criteria are met.
  • Compose technical denial arguments for reconsideration, utilizing both written and telephonic communication.
  • Identify contract protection that can be leveraged to overturn denials.
  • Overcome objections that prevent payment of claims through concise and effective appeal arguments.
  • Utilize effective documentation standards to support a strong historical record of actions taken.
Required Skills and Qualifications
  • Excellent communication skills, with the ability to communicate clearly and concisely, verbally and in writing.
  • Customer orientation, establishing and maintaining long-term customer relationships.
  • Interpersonal skills, able to work effectively with other employees, patients, and external parties.
  • Policies and procedures knowledge, demonstrating understanding of organizational policies and systems.
  • Technical skills, including professional presentation skills and basic mathematical calculations.
Compensation

The estimated salary range for this position is $60,000 - $80,000 per year, based on industry standards and location considerations.



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