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BusinessOperations - Appeals Specialist II - J00909

Mindlance

Role overview

Qualifications

  • High School diploma or GED
  • 1 – 2 years of related experience
  • Knowledge of appeals, disputes and reconsiderations process preferred

Responsibilities

  • Supports the documentation and processing of appeals, disputes and reconsiderations
  • Performs data entry to support tracking and processing of appeals
  • Prepares correspondence for appeals and maintains documentation files
  • Conducts research to evaluate, process, and respond to appeals

Key facts

Hard skills

Other skills

  • Research
  • Communication
  • Timelines
  • Detail Oriented

About the company

Mindlance logo

Mindlance

Staffing & Recruiting

Founded in 1999, Mindlance is one of the largest diversity-owned staffing firms in the US and has been on SIA’s list of Fastest Growing US Staffing Firms for 10 years. Mindlance has also been recognized as one of the consistently best performing partners to industry-leading MSP programs including Allegis, Kelly, TAPFIN, PROUnlimited, Pontoon, GRI, WorkforceLogiq and Agile-1.What started with contingent staffing has developed to a comprehensive portfolio of workforce solutions. Along with industry specific, talent-centric staffing across a range of specializations- Technology, Engineering, Scientific, Clinical Research, Digital, Creative, Marketing, Profession, Mindlance provides Managed Recruitment services- RPO and Direct + Diverse Sourcing, and Pay+ Services- EoR/Payroll, IC Compliance and AoR.Mindlance is also generating alternative talent pipelines that prioritize diversity through three Diverse Talent Acceleration offerings: (1) RebootTalent, a diverse returning talent acceleration service (2) Mindlance Diversphere, a private diverse talent pool aggregated from a network of diversity partnerships and (3) Quintrix Solutions, an upskilling recruit-train-deploy service.With a year-over-year growth rate of 20% and an annual revenue of over $400 million and growing, the Mindlance story is one of calculable achievement, made meaningful by the commitment to grow a mindful way that creates balance in the work and societal ecosystem.Visit www.mindlance.com to learn more about us and our latest job openings.STAFFING INDUSTRY ANALYSTS RECOGNITIONS:Fastest Growing U.S. Staffing Firms (2022, 2021, 2019, 2018, 2017, 2016, 2015, 2014, 2013, 2012, 2011)Largest U.S. Staffing Firms (2022, 2021, 2020, 2019, 2018, 2017, 2016, 2015)Largest Diversity-Owned U.S. Staffing Firms (2022, 2021, 2020, 2019, 2018, 2017, 2016, 2015)Largest IT Staffing Firms (2022, 2021, 2020, 2019, 2018, 2017)Largest Clinical & Scientific Staffing Firms (2022, 2021, 2020, 2019, 2018, 2017)

Company details

Company typeLarge
IndustryStaffing & Recruiting
Company size1001 - 5000

Links

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Job description

Position Purpose:
Supports the documentation and processing of appeals, disputes and reconsiderations to ensure they are in accordance with state and National Committee for Quality Assurance (NCQA) requirements. Support the team to ensure appeals, disputes and reconsiderations are reviewed and processed timely.

Education/Experience:
Requires a High School diploma or GED.
Requires 1 – 2 years of related experience.


Knowledge of appeals, disputes and reconsiderations process preferred.

Performs data entry to support the tracking, logging, and processing of appeals, disputes and reconsiderations in accordance with established regulatory and accreditation guidelines and procedures

Prepares correspondence for appeals, disputes and reconsiderations and maintains documentation files

Reviews and investigates appeals, disputes and reconsiderations requests to determine applicable follow up

Conducts research needed to evaluate, process, and respond to appeals, disputes and reconsiderations to ensure a timely decision

Prepares case files including supporting documentation and determinations needed to review, process, and report the appeals, disputes and reconsiderations

Gathers appeals, disputes and reconsiderations data to track and report on trends and final outcomes to team including conducting outreach for an update on statuses, determinations, and explanations
Performs other duties as assigned

Complies with all policies and standards

EEO:

“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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