Medicare Appeals Specialist

Job Summary

Researching and responding to inquiries related to Medicare appeals, the full-time Medicare Appeals Specialist will provide customer service, conduct research, and manage correspondence in a remote capacity.

Key responsibilities

• Provide timely and accurate responses to inquiries from providers, beneficiaries, and health plans via phone, fax, mail, or email
• Interpret requests and determine appropriate actions to resolve issues with minimal assistance
• Conduct research using federal regulations and policy guidelines to support decisions and responses

Required qualifications

• High School Diploma or equivalent
• Three years of general office experience, with education in administration or business potentially substituting for experience
• One year of experience in Medicare Qualified Independent Contractor appeals or professional business writing in healthcare or legal industries
• Experience with Medicare Part C related appeals activities
• Resided in the United States for at least three of the last five years