Position Summary:
- Responsible for taking incoming requests for first, second level and external appeals
- Work with appeals team for multiple lines of business such as Commercial, Exchange and Medicare
- Ensuring the proper submission of appeals for review by pharmacist and medical directors.
Position Responsibilities:
- Meet established turnaround time requirements.
- Follow all internal Standard Operating Procedures and adhere to HIPAA guidelines and policies.
- Review all cases received, to verify if case meets qualifications for appeal review.
Judi Health
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. They have full-service health benefit management solutions to employers, TPAs, and health plans.