Eligibility Appeal Agent 1

Are you detail-oriented? Enjoy investigating and auditing? Have experience in claims, compliance, or appeals? If so, as an Eligibility Appeal Agent you could be part of our small yet dynamic education requirements team responsible for the certification and registration compliance for over 370,000 registrants here with The American Registry of Radiologic Technologists (ARRT). This fulltime position has a regular schedule of Monday-Friday 8:00am-4:30pm. Convenient Mendota Heights location (with partial hybrid option/minimum of 1-2 days per week onsite), excellent benefits and more!

As the Eligibility Appeal Agent, you'll administer, and process non-ethics related appeals filed by our customers. Using your case management or claims investigations expertise, you'll ensure eligibility appeal process compliance with policies and procedures.

You'll also:

• Review, evaluate, and track eligibility appeal requests

• Prepare data including statistical analyses and reports

• Serve as a subject matter resource to other staff

Duties and Responsibilities

Education Requirements Eligibility Appeals

· Monitor, review, and log incoming eligibility appeals and respond to appeal-related inquiries.

· Serve as an investigator for non-ethics related eligibility appeals.

· Review, evaluate, and track eligibility appeal request forms to ensure completeness, accuracy, and timely processing.

· Prepare case data, findings, and supporting documentation, and route investigation materials to the appropriate ARRT staff for decisions and determinations.

· Draft professional correspondence requesting additional information, communicating appeal outcomes, and explaining ARRT policies and procedures.

· Ensure the eligibility appeals are administered in compliance with established policies and procedures.

· Monitor Federal Emergency Management Agency (FEMA) website for natural disasters to coordinate flagging accounts in databases and update customer dashboards as necessary.

Education Requirements Departmental Support

· Support the Eligibility Appeal team.

· Serve as a resource to assist other staff.

Miscellaneous

· Model and embrace ARRT’s commitment of providing world-class customer service, especially via communications with internal customers in response to questions or data in both verbally and in writing.

· Participate in ongoing learning activities to improve job performance (e.g., goals, development plans, software training).

· Communicate and collaborate with other staff members in a culture of continuous quality improvement.

· Support organizational priorities through active participation in ARRT Projects as assigned.

· Proactively manage and deliver assigned ARRT project work.

· Other duties as assigned and modified as business needs dictate.

Skills and Abilities

· Ability to work both independently and collaboratively.

· Proven written and verbal communication skills with a solid foundation of writing fundamentals.

· Ability to apply critical thinking and problem-solving skills to analyze a variety of different situations with several possible explanations or alternatives and make decisions.

· Ability to easily adapt to change based on the needs of the position, department, or organization.

· Demonstrated ability to prioritize multiple assignments with strong attention to detail and ability to think analytically.

· Proficiency with Microsoft 365 and other platforms and technology.

· Desire and drive to acquire knowledge and skills necessary to accomplish results and new challenges.

· Demonstrated ability to understand and follow written procedures.

· Experience in understanding and adhering to procedures and policies.

Minimum Qualifications

· High School Diploma or equivalent

· Case management, claims adjusting, investigations, litigation, or risk management experience.

Preferred Qualifications

· Associate degree or higher

· Quality Administration or medical-related field experience

· Policy administration experience

· Metric analysis and data presenting experience

· Appeal reconsideration letter writing experience

Physical Demands

Close Visual Acuity: Preparing and analyzing data; viewing a computer screen; and extensive reading

Fingering: Typing, or otherwise working, primarily with fingers

Hearing: Ability to receive detailed information through oral communication

Reaching: Extending hand(s) and arm(s) in any direction

Repetitive Motions: Substantial movements (motions) of the wrists, hands, and/or fingers

Sedentary Work: Sitting most of the time; occasional walking and standing

Talking: Spoken word activities can be relayed accurately, loudly, or quickly