Medicare Appeals Specialist

Job Summary

A company is looking for a Medicare Appeals Specialist.

Key Responsibilities:

• Correspond with patients to provide support and outline appeal strategy when reimbursement is denied
• Review patient medical documentation and prepare persuasive appeal correspondence
• Maintain communication with patients throughout the appeal process and provide support during Administrative Law Judge (ALJ) hearings

Required Qualifications:

• Registered Nurse (RN), Respiratory Therapist (RT), or Licensed Practical Nurse (LPN), or Paralegal required
• Current professional licensure or certification as required by the state of residence
• 3+ years industry experience preferred
• Knowledge of Medicare Regulations preferred
• Experience in reviewing medical records and obtaining third-party payer reimbursement