Appeals Professional

Company: VirtualVocations
Location: Warren
Posted on: November 19, 2024

Job Description:

A company is looking for an Appeals Professional III to perform complex work related to medical dispute resolution and appeals.

Key Responsibilities

Review medical records and write clear, concise, and impartial reconsideration decisions
Make independent decisions based on medical evidence and relevant regulations
Conduct research to support accurate and well-supported decisions regarding appeals

Required Qualifications

Associate's degree or 60+ credit hours towards a Bachelor's degree in healthcare or related field
Three years of experience in medical dispute resolution or Medicare appeals
Experience in writing or making medical necessity decisions
Clinical experience in Nursing, Physical Therapy, Respiratory Therapy, or Occupational Therapy
Preferred experience in Medicare

Keywords: VirtualVocations, Toledo , Appeals Professional, Other , Warren, Ohio

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