Remote Senior Medicare Appeals Processing Representative

Location: Alabama, Alaska, Arizona, Arkansas, California, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, U.S. Virgin Islands, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming

Compensation: To Be Discussed

Staff Reviewed: Fri, May 28, 2021

This job expires in: 4 days

Job Category: Customer Service

Remote Level: 100% Remote

Weekly Hours: Full Time

Employer Type: Employer

Career Level: Experienced

Job Summary

A global healthcare company has an open position for a Remote Senior Medicare Appeals Processing Representative.

Candidates will be responsible for the following:

  • Retrieving assigned cases from queue and based on analysis of issues determining appropriate classification
  • Validating all assigned cases; reviewing appeal documents, correcting appeal types, timeframes and what is being appeals
  • Assigning priority and internal due date based on various regulations which dictate the compliance timeframes

Must meet the following requirements for consideration:

  • High School Diploma required
  • At least 3 Years’ experience Medicare Part C related to Appeals, Claims or Grievances preferred
  • Working knowledge of Medicare Advantage appeal regulations
  • Working knowledge of CHS Explanation of Coverage
  • Strong written and verbal communications skills
  • Proven ability to analyze detailed information

COMPLETE JOB DESCRIPTION

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