Appeals Clinician (Monday - Friday)
PacificSource Health Plans(1 month ago)
About this role
An Appeals Clinician at PacificSource represents the clinical component of member and provider appeals by conducting thorough case reviews, research, and policy interpretation. The role supports decision-making by summarizing clinical findings for Medical Directors and ensuring regulatory compliance across jurisdictions.
Required Skills
- Accountability
- Collaboration
- Communication
- Flexibility
- Active Listening
- Organizational Skills
- Problem Solving
- Teamwork
- Clinical Review
- Policy Interpretation
+2 more
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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