Appeals Specialist

A company is looking for an Appeals Specialist who will research and respond to inquiries related to the appeals process.

Key Responsibilities

Provide customer service and respond to inquiries via phone, fax, mail, or email in a timely manner

Interpret requests and determine appropriate responses to resolve issues with minimal assistance

Conduct research using federal regulations and Medicare / Medicaid policies to support decision-making

Required Qualifications

High School Diploma or equivalent

Three (3) years of general office experience

One (1) year of Medicare Qualified Independent Contractor appeals experience or professional business writing experience in healthcare, customer service, or legal industries

College education or technical training in administration, business, or related areas may substitute for experience on a year-for-year basis

Medicare Part D experience is preferred