• Location
    Maryland Heights, Missouri
  • Job type
  • Category
    Medical & Science - Administration

Adecco is currently assisting a local client in their search to fill Appeals Administrative Coordinator in Maryland Heights, Missouri. Apply now if you meet the qualifications listed below!
Job summary:
IMPORTANT: This position is being recruited for by Adecco’s National Recruitment Center, not your local Adecco Branch Office. To be considered for this position, you must use the “apply now” button to submit your resume. If you have questions about the position, you may contact the recruiter recruiting for this position listed above. For other opportunities available at Adecco go to www.adeccousa.com.


Appeals Administrative Coordinator

What will the candidate be working on while on assignment?

Pulling images, reviewing claims and/or clinical notes and data entering appeals into the tracking system

Position background – what will this role accomplish for the business?

There is currently a backlog of appeals that the team needs support in clearing.

Is this person a sole contributor or part of a team?

Part of a team. The team consists of 3 teams based on regions across the US. We also have 11 staff that support our operations that are part of the OGS team.

Positions in this function are responsible for providing expertise or general support in reviewing, researching,
investigating, negotiating and resolving all types of appeals and grievances. Communicates with appropriate parties
issues, implications and decisions. Analyzes and identifies trends for appeals and grievances.
1. Review, Research, and Analyze Appeal or Grievance Information
2. Utilize Computer Systems to Research, Track, Document and Communicate Appeal
3. Make Benefit or Administrative Appeal or Grievance Determinations
4. Communicate Appeal or Grievance Status or Resolution

Will need Basic computer knowledge including navigating various systems to find specific information

How will performance be measured?
Daily production requirements and quality of data entry

What skills/attributes are a must have?
• Experience applying specific policies or standards to daily work to assure compliance with relevant regulations.
• Ability to interact in a courteous and businesslike manner with colleagues as well as external facility staff
• 5-10 year of basic PC skills, Microsoft Office (Word, Excel, Outlook)
• 5+ years previous customer service experience
• 2 years or more of college completed
• Experience working with ICD-9 and CPT codes
• Experience with analyzing patient records.
• Experience working in a mental health/substance abuse facility
• Ability to pay close attention to detail and a tolerance for handling large amounts of data.

What skills/attributes are nice to have, and set a candidate apart?
•Knowledge of HIPAA compliance is preferred
•Previous experience with benefits and medical terminology a plus
•Prior experience in healthcare
Previous appeals experience in a healthcare setting

Where is the work to be performed (Optum location, or telecommute)?
Optum office

Maryland Heights, MO

What are the work hours?
8am-5pmCT (can be slightly flexible if needed by an hour each way)

If you have any questions surrounding the application process, please feel free to reach out to Yulia Le Good, Yulia.legood@adeccona.com, tel. 631-844-2804

The Adecco Group is a global leader in HR services. Our group connects over 700,000 associates with our business clients each day through our 6,600 offices in over 70 countries and territories around the world. We offer employment opportunities at any stage in your professional career. Contact us today to discuss available contract and direct hire positions. Adecco Group provides one of the most comprehensive benefits packages in the industry to contract workers to include Holiday, 401(k) and Insurance Benefit Plans.
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Reference number US_EN_2_022862_401029