Providing independent second-level determinations, the full-time Licensed Appeals Professional will review medical records and write clear, impartial decisions on appeals and disputes while working remotely. Key responsibilities Reviews medical records and writes clear reconsideration/dispute resolution decisions Makes independent decisions based on medical evidence in accordance with relevant regulations and policies Conducts research on federal regulations and medical practices to support accurate decision-making Required qualifications Associate's degree or 60+ credit hours towards a Bachelor's degree in healthcare or related discipline Three years of experience in medical dispute resolution or Medicare appeals in a healthcare setting Experience in writing medical necessity decisions Preferred experience in Medicare Part A Appeals or related healthcare coding Resided in the U.S. for at least three of the last five years
Licensed Appeals Professional in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.