Remote Healthcare administration Jobs • Problem Solving

Design and build a health plan from the ground up as an Clinical Appeals Coordinator. Reporting to the Health Plan Manager of Utilization Review, the Appeals Nurse, will be an integral member of the health plan’s medical management team. The Appeals Nurse will investigate and process medical necessity requests from both members and providers. The Clinical Appeals Coordinator is a collaborative member of the Medical Management team.

Serves customers by answering incoming calls utilizing Denver Health and Departmental policies/processes to resolve customer health information requests and directing calls to the appropriate area when necessary. Provides assistance to Denver Health staff by collecting demographic, medical complaint and key information required to facilitate appropriate patient care and call resolution. Educates customers on additional services by recognizing opportunities to enhance the customers' experience and meet their needs.