Moda Health
Join to apply for the
Provider Correspondence Coordinator I
role at
Moda Health 1 month ago Be among the first 25 applicants Join to apply for the
Provider Correspondence Coordinator I
role at
Moda Health Get AI-powered advice on this job and more exclusive features. About Moda
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together. Let’s do great things, together!
About Moda
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.
Position Summary
Moda Health is seeking a Provider Correspondence Coordinator in our Medical Claims department. This position researches and provides written response to medical provider correspondence and appeals regarding claim edits, processing, authorizations and medical necessity reviews; researches and provides written response to medical inquiries regarding benefit and plan design issues.
This is a FT WFH role.
Pay Range
$19.05 - $21.43 hourly (depending on experience)
Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.
Please fill out an application on our company page, linked below, to be considered for this position.
https://j.brt.mv/jb.do?reqGK=27758650&refresh=true
Benefits
Medical, Dental, Vision, Pharmacy, Life, & Disability 401K- Matching FSA Employee Assistance Program PTO and Company Paid Holidays
Required Skills, Experience & Education
Responds to provider appeals and related correspondence. Interacts with physician/provider offices by letter or phone to gather additional information regarding claim disputes. Performs a total claim review to determine over/underpayment on problem claims. Works with Claims Support to adjust previously processed claims. Documents accurately in Facets regarding outcome of claims disputes. Meets the departments established standards for case completion. Other duties as assigned.
Primary Functions
Responds to provider appeals and related correspondence. Interacts with physician/provider offices by letter or phone to gather additional information regarding claim disputes. Performs a total claim review to determine over/underpayment on problem claims. Works with Claims Support to adjust previously processed claims. Documents accurately in Facets regarding outcome of claims disputes. Meets the departments established standards for case completion. Other duties as assigned.
Together, we can be more. We can be better.
Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training.
For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email.
#INTONLY Seniority level
Seniority level Entry level Employment type
Employment type Part-time Job function
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Provider Correspondence Coordinator I
role at
Moda Health 1 month ago Be among the first 25 applicants Join to apply for the
Provider Correspondence Coordinator I
role at
Moda Health Get AI-powered advice on this job and more exclusive features. About Moda
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together. Let’s do great things, together!
About Moda
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.
Position Summary
Moda Health is seeking a Provider Correspondence Coordinator in our Medical Claims department. This position researches and provides written response to medical provider correspondence and appeals regarding claim edits, processing, authorizations and medical necessity reviews; researches and provides written response to medical inquiries regarding benefit and plan design issues.
This is a FT WFH role.
Pay Range
$19.05 - $21.43 hourly (depending on experience)
Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.
Please fill out an application on our company page, linked below, to be considered for this position.
https://j.brt.mv/jb.do?reqGK=27758650&refresh=true
Benefits
Medical, Dental, Vision, Pharmacy, Life, & Disability 401K- Matching FSA Employee Assistance Program PTO and Company Paid Holidays
Required Skills, Experience & Education
Responds to provider appeals and related correspondence. Interacts with physician/provider offices by letter or phone to gather additional information regarding claim disputes. Performs a total claim review to determine over/underpayment on problem claims. Works with Claims Support to adjust previously processed claims. Documents accurately in Facets regarding outcome of claims disputes. Meets the departments established standards for case completion. Other duties as assigned.
Primary Functions
Responds to provider appeals and related correspondence. Interacts with physician/provider offices by letter or phone to gather additional information regarding claim disputes. Performs a total claim review to determine over/underpayment on problem claims. Works with Claims Support to adjust previously processed claims. Documents accurately in Facets regarding outcome of claims disputes. Meets the departments established standards for case completion. Other duties as assigned.
Together, we can be more. We can be better.
Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training.
For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email.
#INTONLY Seniority level
Seniority level Entry level Employment type
Employment type Part-time Job function
Job function Other Industries Insurance Referrals increase your chances of interviewing at Moda Health by 2x Get notified about new Coordinator jobs in
Portland, OR . Senior Administrative Assistant - Global Materials Supply Chain
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Assistant Community Manager - Station Place Tower
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We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
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