Medicare Appeals Specialist

Job Summary

A company is looking for an Associate Specialist, Appeals & Grievances with Medicare Member Grievances experience.

Key Responsibilities

• Review and resolve member and provider complaints, ensuring compliance with CMS standards
• Research claims issues and prepare documentation for appeals and grievances
• Generate denial letters and maintain related statistics and reporting

Required Qualifications

• At least 1 year of experience in claims or customer/provider service in a healthcare setting
• Customer service experience
• Organizational and time management skills
• Proficiency in Microsoft Office suite or applicable software programs
• Completion of a healthcare-related vocational program is preferred