Medicare Appeals Coordinator

Job Summary

A company is looking for a Medicare Appeals Intake Coordinator.

Key Responsibilities

• Ensure proper appeal classification and identification of valid appeals through intake and triage of cases
• Receive, review, and log appeal requests into applicable systems while maintaining accurate records
• Identify urgent cases and ensure timely routing to appropriate areas in compliance with regulations

Required Qualifications

• High School Diploma or equivalent required
• 1+ years of experience in Managed Care Organization, health insurance, or related fields required
• Preferred experience in Medicare appeals or handling requests related to dual-eligible members
• Familiarity with Medicare regulations and CMS guidelines preferred
• Basic knowledge of processes for enrollees with both Medicare and Medicaid benefits preferred