Medical Appeals Specialist

Responsibilities

• Accurately receive, review, and forward appeal documents and requests in compliance with federal and state regulations, contractual requirements, and company standards.
• Process appeal documents and requests efficiently and accurately.
• Upload media to accounts and verify successful uploads.
• Distribute designated media to appropriate departments.
• Meet daily and weekly production standards.
• Recommend workflow and process improvements to increase efficiency, accuracy, and streamlining.
• Complete assigned tasks accurately and efficiently.

Requirements

• High school diploma or GED.
• 5+ years of relevant office, administrative, or support experience with progressively complex responsibilities; healthcare experience preferred.
• Knowledge of healthcare audits, appeals, claims processing, billing, and recovery processes, preferably involving Medicare and Medicaid.
• Strong multitasking, prioritization, adaptability, and deadline-management skills.
• Intermediate Microsoft Excel and Microsoft Word skills.
• Strong knowledge of medical documentation.
• Ability to work independently while maintaining accuracy and quality under strict deadlines.
• Strong verbal and written business communication skills.
• Courteous, professional, respectful, dependable, conscientious, detail-oriented, and reliable approach.

Compensation & Benefits

• Work from anywhere in the US.
• Pay range: $21.00/hour, equivalent to $43,680 annually.
• Medical, dental, and vision benefits.
• FSA/HSA.
• Tuition reimbursement.
• 401(k) with company match.
• Additional health and wellness benefits and perks.
• Flexible work environment.