Appeals Coordinator (Fully Remote)

Reviews appeals of adverse benefit determinations under federal and state law. Exercises independent judgment to ensure decisions are fair and compliant. Responsibilities: Researches appeal cases for medical necessity and coverage policy. Responds to state insurance department complaints and collaborates with medical divisions. Qualifications & Culture: Requires active RN license, 5 years clinical nursing, and 2 years utilization review experience. Benefits include tuition reimbursement, onsite gym, onsite dining, and wellness incentives. Arkansas Blue Cross and Blue Shield Arkansas Blue Cross and Blue Shield is a health insurance provider serving Arkansas. It is consistently ranked as one of the best places to work in Central Arkansas, with an inclusive culture and an average employee tenure of 10 years. #J-18808-Ljbffr