Appeals Clinician (Monday - Friday)
PacificSource Health Plans(1 month ago)
About this role
An Appeals Clinician at PacificSource provides the clinical perspective within the appeals process by producing concise, evidence-informed clinical summaries for medical director review. The role supports regulatory compliance and helps ensure members receive appropriate determinations across medical and behavioral health cases.
Required Skills
- Clinical Review
- Case Review
- Policy Interpretation
- Medical Coding
- Research
- Collaboration
- Communication
- HIPAA Compliance
- Data Analysis
Qualifications
- Registered Nurse
- Licensed Behavioral Health Specialist
- Unrestricted State License
About PacificSource Health Plans
pacificsource.comPacificSource offers health insurance plans for individuals, families, and employers. A Northwest not-for-profit, we put members first.
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