Job Summary

A healthcare company has a current position open for a Remote Medicare Appeals Professional II.

Individual must be able to fulfill the following responsibilities:

• Review medical records/case file
• Make sound, independent decisions based on medical evidence
• Respond to and ensures that all appeal/dispute issues

Required Skills:

• Associate's or 60 or more credit hours towards a Bachelor’s degree from an accredited college
• Additional experience in Medicare appeals, medical review, clinical, or other related experience
• 3 years of medical dispute resolution or Medicare appeals, medical review, clinical, or related experience
• Healthcare Professional with demonstrated experience writing or making medical necessity decisions
• Nursing, Physical Therapy, Respiratory Therapy or  Occupational Therapy experience
• Clinical experience