Job Details

Do you want to work for a company that Forbes named one of the Top 50 Most Innovative Companies? Are you looking to fast-track your career with one of LinkedIn's top companies in the U.S.? If so, keep reading! Title of Job: Remote Clinical Appeals Representative Location: REMOTE (anywhere in the US) CSI Companies is hiring a Remote Clinical Appeals Representative for our Fortune 100 healthcare client in Minnetonka, MN. This job can be worked from anywhere in the US as long as you have high speed internet and a distraction-free home office area. Job Summary
The Remote Clinical Appeals Representative is primarily responsible for managing member grievances and potential quality of care issues from both internal and external sources. This role ensures timely documentation, coordination, and follow-up with provider offices while maintaining compliance with health plan turnaround times. Pay : $20.50 - 25.50 an hour based on experience (overtime will be paid at 1.5 times the normal hourly pay rate). Hours: Full Time - Monday-Friday 8am-4:30pm Why this Opportunity?

• Top ranked company in Fortune's "World's Most Admired Companies" 14 years in a row .
• This healthcare client is ranked number one in key attributes of reputation:
  • Innovation
  • People management
  • Social responsibility
  • Quality of Management
  • Financial soundness
  • Long-term investment value
  • Quality of products
  • Services and global competitiveness

Status: Long Term Consultant. Long term consultant, no end date, with good job stability. There is always potential for conversion to FTE status with the client for the right employee upon business needs. Almost all of the positions within this client start off as a consultant due to being a Fortune 100 company.
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Effective Date / Tentative Start Date: Interviewing Immediately
Job Duties:

• Serve as the primary contact for member grievances and potential quality of care issues
• Perform data entry, record requests, and follow-up actions to ensure timely case resolution
• Coordinate and communicate with provider offices and internal departments
• Adhere to established turnaround times

Requirements

• High school diploma or equivalent
• Proficiency with data entry and documentation in multiple systems
• A reliable high-speed internet connection (the faster the better!)
• Ability to pass a background check and drug test
• Private, quiet, and distraction-free workspace in a room with a closed-door

Highly Preferred

• Large corporation experience
• Health plan / managed care / healthcare industry experience
• Knowledge of grievance, appeals, or quality of care processes

WHO SHOULD APPLY?
If you have experience in clinical appeals, potential quality issues, quality of care reviews, or member grievances, we would love for you to apply! Apply to become part of the team that is not only changing people's lives for the better but changing the health care system for the next generations to come. About Us
The CSI Companies is a recruiting firm established in 1994 that has been awarded "Best of Staffing" for 8 years in a row. We provide outstanding services to the world's leaders in the healthcare field as well as other organizations. For consideration, please submit your resume with all of your relevant experience included on it for immediate consideration. Only those candidates identified for an interview will be contacted.
Benefits Offered:

• Weekly pay
• Medical, dental, and vision coverage
• Voluntary Life and AD&D coverage
• Paid Training
• Opportunity for advancement upon performance and availability

APPLY NOW and a recruiter will be in touch with you to schedule a phone screening!