Full-Time

Appeals Specialist II

Posted on 11/21/2024

Solventum

Solventum

Compensation Overview

$46.4k - $56.7kAnnually

+ Variable Incentive Pay

Entry, Junior

No H1B Sponsorship

Remote in USA

Category
Risk & Compliance
Legal & Compliance
Requirements
  • Bachelor’s Degree or higher AND 1 year experience of Medicare appeals process
  • OR
  • High School Diploma/GED from AND 2+ years of Medicare appeals process
  • Proficient communications skills
  • Proficient data entry skills
  • Demonstrated ability to work effectively and exercise sound business judgement in a team environment, as well as independently
  • Ability to communicate proficiently, both verbally and in writing with internal and external customers
  • Consistently meet deadlines and maintain production and quality levels as established by management
  • Decision making skills
  • Organizational Skills
  • Excellent accounting skills
  • Intermediate phone skills
  • Proficient Microsoft office skills
  • Must be legally authorized to work in country of employment without sponsorship for employment visa status (e.g., H1B status).
Responsibilities
  • Evaluating denied Medicare primary insurance claims in a timely manner
  • Appeal denied claims through either Redetermination, Reconsideration, or Administrative Law Judge process, in accordance with State and Federal laws
  • Proactively investigating and analyze patient charts by reading documents and computer-based research
  • Researching and concisely summarizing the finding in medical records and document where appropriate
  • Independently recognizing issues/problems and trends with the ability to communicate with management their findings

Company Stage

N/A

Total Funding

N/A

Headquarters

N/A

Founded

N/A