Founded in 1978,Â Universal Health Services, Inc. (UHS)* is one of the nationâ€™s largest and most respected healthcare management companies, operating through its subsidiariesâ€"acute care hospitals, behavioral health facilities and ambulatory centers nationwide. With more than 74,000 people employed by UHS subsidiaries, UHSâ€™s business strategy is to continue to grow by building or purchasing healthcare facilities across the country, while continuing to strengthen UHSâ€™s well-reputed franchise with itsÂ customaryÂ exceptional service and effective cost control. Our success is driven by a service philosophy based on integrity, competence, compassion, and a responsive management style. UHS has been recognized as a Fortune 500 company and is listed as one of Fortuneâ€™s Most Admired Companies. UHSâ€™s Acute Care Division is comprised of 25 high performing hospitals and several ambulatory care facilities across the nation and prides itself on providing superior patient care.Â
Prominence Health Plan, established in Reno in 1993 as St. Maryâ€™s Health Plan, was acquired in 2014 by Universal Health Services (UHS), one of Fortune Most Admired Companies.Â
In addition to the HMO, Prominence Health Plan also offers Point of Service health plans, a preferred health insurance company that offers Preferred Provider Organization (PPO) health plans, and CDS Group Health, a third-party administrator.
We are a fast-growing, rapidly-changing healthcare organization offering the excitement of a start-up with the support of a Fortune 500 company. We are looking for talented, enthusiastic people to help shape the future of our organization.
Job Summary:Â Under the direction of the Member Services Manager, the Appeals Specialist is responsible for
ensuring the appropriate processing and responding to written member and provider complaints, appeals and
inquiries from the Division of Insurance in accordance with state and federal regulations, company policies and
NCQA/HEDIS standards. Compile, analyze and maintain statistical data and trends to maintain the highest level of
standards. Additional responsibilities include assuming responsibility of the Department in the absence of the