Marpai Administrators LLC

QA Engineer

• Case management: Receive, prioritize, and process incoming written and verbal appeal requests.
• Investigation and Analysis: Conduct thorough investigations by gather and analyzing all necessary documentation, including medical records, claim details, and denial letters to undertand the full scope of the case.
• Documentation: Accurately document all communications and case information in the appeals tracking database and case files, ensuring meticulous record-keeping.
• Communication: Draft and prepare accurate, professional response letters and other client-facing communications to inform all involved parties of the appeal status and resolution.
• Compliance: Ensure all appeal activities and correspondence meet established internal policies and external regulatory timeframes and standards.
• Coordination: Collaborate with various internal departments to gather information, coordinate case reviews and ensure comprehensive support of each appeal.
• Trend Reporting: Monitor appeal trends, identify root causes of denials and report findings to management to support process improvement initiatives.

Quality Assurance Appeals Coordinator