Lubbock, TX, USA
11 days ago
Claims Appeals Representative - Case Management

Providence caregivers are not simply valued – they’re invaluable. Join our team at Covenant Medical Center and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

 

Works collaboratively with Case Management (CM) Leadership, Case Managers (CM), Complex Discharge Planners (CDP) and other Resource Center (RC) staff in the CM department to support maximum reimbursement for CHS from payors.  Communicates clinical reviews and refers payor questions to appropriate CM. Collaborates with Patient Financial Services, Administration, CMs, physicians and financial counselors to ensure appropriate reimbursement from third party, private and government payors, for medical services provided in acute care setting.

Schedule Availability: 

This role is an onsite position and will report onsite daily as scheduledFlexibility to work a rotating schedule, including weekends & holidaysPositions specified as “on call/per diem” refer to employment consisting of shifts scheduled on an “as needed basis” to fill in for staff vacancies

 

Preferred Qualifications:

Associate Degree3 or more years of experience in managed care claims/reimbursement setting or experience working in another other healthcare field1 or more years of experience in managed care claims / reimbursement1 or more years of experience in a healthcare environmentCustomer service experienceHealthcare experience

 

Why Join Providence? 

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security.  We take care of you, so you can focus on delivering our mission of caring for everyone, especially the most vulnerable in our communities. 

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