Appeals Specialist

Job Summary

A company is looking for an Appeals Specialist who will research and respond to inquiries related to the appeals process.

Key Responsibilities

• Provide customer service and respond to inquiries via phone, fax, mail, or email in a timely manner
• Interpret requests and determine appropriate responses to resolve issues with minimal assistance
• Conduct research using federal regulations and Medicare/Medicaid policies to support decision-making

Required Qualifications

• High School Diploma or equivalent
• Three (3) years of general office experience
• One (1) year of Medicare Qualified Independent Contractor appeals experience or professional business writing experience in healthcare, customer service, or legal industries
• College education or technical training in administration, business, or related areas may substitute for experience on a year-for-year basis
• Medicare Part D experience is preferred