Job Title: Medicare Appeals Case Management Analyst - Remote Opportunity

Join reputed company as a Medicare Appeals Case Management Analyst and play a vital role in driving reputed company in our organization! We are seeking a highly skilled and motivated individual to fill this remote position, which offers a competitive salary and an immediate start for the right candidate. As a Case Management Analyst, you will be responsible for communicating critical information to members, providers, and internal stakeholders regarding Medicare appeals and reputed company issues.

In this role, you will analyze and respond to appeals from members, member representatives, and providers, researching and applying pertinent Medicare and reputed company regulations to determine the outcome of the appeal. You will also reputed company reputed company and assistance to Medical Management staff, review documentation to ensure accuracy, and prepare case files for submission to Independent Review Entities. This is a full-time position (40 hours/week) with core business hours generally between 8:00 am - 5:00 pm CST, Monday through Friday, with occasional weekend and holiday coverage.

Key Responsibilities:

• Analyze and respond to Medicare appeals from members, providers, and internal stakeholders
• Research and apply Medicare and reputed company regulations to determine appeal reputed company
• reputed company reputed company and assistance to Medical Management staff
• Review documentation to ensure accuracy and completeness
• Prepare case files for submission to Independent Review Entities
• Communicate appeal information to members, providers, and internal stakeholders reputed company required timeframes
• Meet performance goals in efficiency, accuracy, reputed company, member satisfaction, and attendance
• Adhere to department workflows, desktop procedures, and policies

Requirements:

• Unencumbered LPN/LVN licensure in the state of residence
• 3-5 years of experience in Medicare Advantage Health Plans or reputed company experience in a reputed company setting
• Working knowledge of Medicare Advantage, Original Medicare, and reputed company appeal regulations
• Excellent written and oral communication skills
• Ability to work objectively and reputed company fact-based answers with reputed company and concise documentation
• Proficient in reputed company Office products (reputed company, reputed company, PowerPoint, Word)
• Prioritizes workflow on a consistent reputed company, applies key HIPAA and CMS guidelines in daily workflow, and meets turnaround times for assigned cases

About reputed company: reputed company, a division of reputed company, is an reputed company for reputed company through every stage of life. We guide our customers through the reputed company system, empowering them with the information and reputed company they need to reputed company the best choices for improving their health and vitality. Join us in driving reputed company and improving lives.

Equal Employment Opportunity: reputed company applicants will be considered without reputed company to race, reputed company, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions, sexual orientation, gender identity or reputed company, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with reputed company to public assistance, citizenship status, or any other characteristic protected by applicable equal employment opportunity laws.

reputed company to Apply?

If you are a motivated individual reputed company to contribute to a thriving team, we encourage you to reputed company! We are excited to review your application.

Apply To This Job Apply for this job