VIVA HEALTH · 23 hours ago
Provider Appeals Specialist I
Birmingham, Alabama, United States
Full-time
Onsite
Entry Level
1+ years expVIVA HEALTH is part of the University of Alabama at Birmingham (UAB) Health System, providing quality healthcare. The Provider Appeals Specialist is responsible for the intake and processing of appeals from providers, ensuring timely and accurate documentation and resolution according to regulations and policies.
Health CareInsurance
Responsibilities
Record appeals in the department’s system(s) timely and accurately, ensuring all necessary documentation is uploaded with the case
Classify contracted and non-contracted provider appeals according to federal and state regulations, as well as internal and organizational policies and procedures
Route appeals to other departments as needed for investigation to resolve the cases
Route other incoming mail, email and faxes to the appropriate departments in a timely manner
Assist with recording Medicare appeals and grievances requests in the department’s system(s) timely and accurately, ensuring all necessary documentation is uploaded with the case
Be available to work 8 a.m. to 5 p.m. Monday through Friday at the Company’s corporate headquarters, plus overtime and weekends as required
Qualification
Required
High School Diploma or GED
1+ years' experience in managed care, health care customer service, or appeals and grievances
Excellent written and verbal communication skills, interpersonal skills, organization skills, and the ability to handle multiple tasks
Ability to carefully follow processes in sequential order
Ability to meet established productivity, schedule adherence, and quality standards
Attention to detail and ability to meet strict deadlines
Ability to learn and use various computer platforms and ability to use applications of Microsoft Office
Ability to use critical thinking skills to develop solutions to non-clinical issues using fact-based decision making
Ability to work occasional planned and unplanned overtime to meet deadlines with minimal supervision
Preferred
Associate's Degree
1+ years' experience processing Medicare appeals and grievances
Knowledge of Medicare regulations
Experience with administrative and/or coordinator positions with exposure to protected health information (PHI)
Benefits
Comprehensive Health, Vision, and Dental Coverage
401(k) Savings Plan with company match and immediate vesting
Paid Time Off (PTO)
9 Paid Holidays annually plus a Floating Holiday to use as you choose
Tuition Assistance
Flexible Spending Accounts
Healthcare Reimbursement Account
Paid Parental Leave
Community Service Time Off
Life Insurance and Disability Coverage
Employee Wellness Program
Training and Development Programs to develop new skills and reach career goals
Employee Assistance Program
Company
VIVA HEALTH
VIVA HEALTH is the preferred healthcare provider which provides Health Insurance, Medicare, Medicaid and Healthcare.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
C
Cardwell Feagin
COO
Recent News
2025-05-16
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