Medical Appeals Specialist (SCA)

📋 Description

• Process medical appeals and related documents with accuracy and timeliness.
• Review, reconcile, and route appeal documentation while ensuring regulatory compliance.
• Serve as a liaison between providers, internal teams, and stakeholders in the appeals process.
• Meet production standards and manage multiple assignments in a dynamic environment.
• Identify workflow inefficiencies and recommend improvements to boost efficiency and accuracy.
• Collaborate across locations and functions to resolve issues and implement practical solutions.

🎯 Requirements

• High school diploma or GED required.
• At least 5 years of relevant office, administrative, healthcare, or support experience.
• KNowledge of healthcare audits, medical appeals, claims processing, billing, and recovery processes.
• Working knowledge of Medicare and Medicaid processes preferred.
• Strong ability to review medical documentation and handle sensitive information.
• Intermediate proficiency with Microsoft Excel and Microsoft Word.

🎁 Benefits

• $21.00 per hour base pay.
• Fully remote work from anywhere in the United States.
• Medical, dental, and vision insurance options.
• FSA/HSA options and 401(k) with company match.
• Tuition reimbursement and additional health and wellness benefits.
• Flexible, empowering work environment and focus on healthcare operations improvements.