Appeals Coordinator II
Company: VirtualVocations
Location: Vista
Posted on: May 21, 2025
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Job Description:
A company is looking for an Appeals Coordinator II to assist
with administrative work in the Appeals Department.
Key Responsibilities
Prepare and disseminate case files for external reviews and manage
appeals from non-participating providers
Ensure timely review, research, and resolution of appeals,
grievances, and complaints while maintaining compliance with
guidelines
Consult with managers and subject matter experts to resolve health
plan requests or provider inquiries effectively
Required Qualifications
Associates Degree or equivalent experience in the healthcare
industry
3+ years of experience in the healthcare sector
Experience in inpatient claims, DRG, and high-cost outlier claims
preferred
Proficiency in MS Office, particularly Excel
Knowledge of claim payment methodology
Keywords: VirtualVocations, Costa Mesa , Appeals Coordinator II, Other , Vista, California
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