Clinical Appeals Advocate
Core
Patient advocate supporting individuals denied insurance coverage for Baxter's Respiratory Health products to secure access to medically necessary therapies.
Role type
Clinical Appeals Advocate
Builds
Persuasive appeal submissions and clinical case summaries for commercial and government payers
Domain
Healthcare / Respiratory Health / Insurance Appeals
Deliverable
client delivery
Required skills
Clinical case assessment, appeal strategy development, clinical documentation gathering, payer policy navigation, patient communication, regulatory compliance knowledge
Preferred skills
Medical record review, third-party reimbursement processing, critical thinking, time management
Technologies
Microsoft Office
Responsibilities
Assess cases and develop appeal strategies, communicate appeal strategies to patients, create clinical case summaries, process favorable appeal decisions, build relationships with case managers and medical directors, ensure adherence to payer policies
Seniority
Mid-level, hands-on IC