Appeals Clinician (Monday - Friday)
PacificSource Health Plans(1 month ago)
About this role
The Appeals Clinician at PacificSource serves as the clinical representative for member and provider appeals, providing expert review and interpretation of medical and behavioral health information to inform determinations. The role supports regulatory compliance and effective communication with medical leadership. It contributes to the organization's mission of helping members access quality, affordable care.
Required Skills
- Case Review
- Clinical Knowledge
- Research
- Policy Application
- Communication
- Collaboration
- Customer Service
- Data Analysis
- Lean Methodologies
- HIPAA Compliance
+3 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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