Telecommute Healthcare Big Box Appeals Professional III

Job Summary

A non profit that helps hospitals, physician's offices, and nursing homes improve care is filling a position for a Telecommute Healthcare Big Box Appeals Professional III.

Core Responsibilities of this position include:

• Overseeing and reviewing medical records/case file
• Making sound, independent decisions based on medical evidence in accordance with statutes, regulation, rulings, and policy
• Participating in pre-decisional discussions for the purpose of obtaining information

Skills and Requirements Include:

• Associate's degree
• 5 years of medical dispute resolution or Medicare appeals, medical review, clinical, or related experience in a healthcare setting
• Healthcare Professional with demonstrated experience writing or making medical necessity decisions
• Medicare experience
• Nursing, Physical Therapy, Respiratory Therapy or Occupational Therapy experience