UM Appeals Support Specialist

Job Summary

Supporting the UM department functions, the full-time UM Appeals Follow-up Support Specialist will obtain service authorization, monitor compliance, and assist with the appeals process while working remotely.

Key responsibilities

• Obtain and monitor service authorizations for Medicare and Non-Medicare funded services
• Prepare appeal summaries and correspondence while documenting information for tracking and trending data
• Serve as a liaison with Medicare and non-Medicare funding entities, responding to clinical information requests

Required qualifications

• High School diploma or GED required
• Minimum two (2) years of experience in medical insurance, medical records, or medical office settings
• Experience with Medicare, State, Hospice, HMO, PPO, and traditional insurance regulations preferred
• Post High School business or college coursework preferred
• Familiarity with EPIC or electronic medical records is preferred