Appeals Specialist

Job Summary

Working remotely in a full-time capacity, the Appeals Specialist will perform moderately complex appeals work, including researching inquiries and responding to providers and beneficiaries while managing phone discussions and documentation processes.

Key responsibilities

• Provides customer service by researching and responding to inquiries received via phone, fax, mail, or email in a timely manner
• Conducts research on federal regulations and Medicare/Medicaid policies to make well-supported decisions
• Initiates and coordinates reconsideration phone discussions between suppliers and decision makers, ensuring adherence to schedules

Required qualifications

• Three years of general office experience
• High School Diploma or equivalent
• One 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-per-year basis
• Experience directly relevant to the specific task order or project is preferred