Claims Admin Appeals Coordinator
Core
Provide clerical and administrative support to the Claims Department of an insurance Third-Party Administrator (TPA), ensuring accurate processing and maintenance of claims and appeals.
Role type
Administrative Coordinator
Builds
Claims processing workflows and appeal determinations
Domain
Insurance / Healthcare Administration
Required skills
Data entry, Microsoft Office proficiency, Claims processing, Recordkeeping, Deadline management
Preferred skills
Insurance claims experience, TPA environment familiarity, HealthPac software proficiency, HIPAA/PII handling
Responsibilities
Processing and tracking member/provider appeals, Researching claims and plan provisions, Coordinating information for appeal determinations, Monitoring appeal deadlines, Identifying trends to improve tools, Performing administrative follow-up
Seniority
Entry-level to Mid-level