Texas Appeals Specialist

Job Summary

A company is looking for an Appeals Specialist II to support multiple Medicaid health plans in a fully remote position.

Key Responsibilities

• Transfer and evaluate cases from CenPAS
• Review provider disputes and reconsideration requests
• Respond to claims and utilization management inquiries

Required Qualifications

• High school diploma or equivalent
• Knowledge of reviewing claims and authorizations
• Familiarity with TruCare and Amisys systems
• Data entry/typing skills (minimum 40 wpm)
• Knowledge of claims/coding and authorizations