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Responsibilities:
- Manages appeals caseload.
- Provides guidance and resolves cases daily with Appeals and Case review staff.
- Coordinates worklists and completion of cases.
Qualifications:
- Requires nursing degree and three years of experience as a hospital care coordinator or insurance case management.
- Requires current Standards of Care & Criteria, working knowledge of Intequal and/or Milliman.
- Requires the ability to train and direct employees.
Preferred:
- Bachelor's degree in nursing and five years of experience in care coordination or related field
- Leadership experience.
- Certification as Certified Case Manager (CCM) or Accredited Case Manager (ACM).
Northside Hospital
Northside Hospital is an award-winning and state-of-the-art healthcare provider that is constantly growing. They are expanding the quality and reach of their care to patients and communities, creating more opportunity for healthcare professionals in Atlanta and beyond.