Claims Appeals Representative, Case Management - Lubbock

Providence Health & Services
life insurance, parental leave, 401(k)
United States, Texas, Lubbock
Jun 24, 2025
Description 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 is an onsite role that will report into the hospital daily, as scheduled Willingness to work a flexible, rotating schedule, including weekends Flexibility to work evenings, weekends, and holidays as scheduled Work Status Available: Per Diem / On Call - Day Shift Positions 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 Degree 3 or more years of experience in managed care claims/reimbursement setting or experience working in another other healthcare field Customer service experience Healthcare experience 1 or more years of experience in managed care claims / reimbursement 1 or more years of experience in a healthcare environment Customer service experience Healthcare experience Experience May Include: 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. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits. Requsition ID: 371739 Company: Covenant Jobs Job Category: Claims Job Function: Revenue Cycle Job Schedule: Per-Diem Job Shift: Day Career Track: Admin Support Department: 8009 UTILIZ REVIEW TX CMC Address: TX Lubbock 3615 19th St Work Location: Covenant Medical Center Workplace Type: On-site Pay Range: $17.12 - $26.18 The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.