Appeals Specialist

Position Overview:

As an Appeals Specialist, you will be at the forefront of our provider/supplier service operations, handling phone inquiries, call logs, voicemail messages, and email inquiries. Your primary responsibilities will include triaging provider/supplier inquiries, documenting interactions in our case management system (PAMS) and ensuring timely and accurate responses to queries.

Key Responsibilities:

1. Taking Phones:

- Professionally handle incoming phone calls from providers/suppliers.

- Address inquiries, provide information, and escalate issues as needed.

1. Call Logs Entries:

- Accurately log all phone interactions and inquiries.

- Categorize and prioritize calls for effective follow-up and resolution.

1. Monitoring Voicemail:

- Regularly check and respond to voicemail messages in a timely manner.

- Triage tier 1 inquiries and escalate complex issues to the appropriate teams.

1. Monitoring Email Inquiries:

- Monitor and manage the provider/supplier support email inbox.

- Respond to tier 1 inquiries, provide information, and escalate as necessary.

1. Document in PAMS:

- Utilize our internal case management system (PAMS) to document provider/supplier interactions and case details.

- Ensure accurate and comprehensive documentation of all provider/supplier-related activities.

1. Provider/supplier Inquiry Triage:

- Evaluate and categorize provider/supplier inquiries based on complexity and urgency.

- Triage tier 1 issues for quick resolution and escalate tier 2 issues to the appropriate departments.

Qualifications:

- Excellent communication skills, both verbal and written.

- Strong organizational and multitasking abilities.

- Previous experience in provider/supplier support or a related field is a plus.

- Familiarity with cases management systems.

"C-HIT is an EOE, including disability and veterans."