Medical Appeals Specialist (SCA)
$43,680–$43,680 year
RemoteUnited States
United StatesRemoteFull Time$43,680–$43,680 yearHigh School Or EquivalentSmall
Full TimeHigh School Or EquivalentSmall
Job Summary
Receive, review, and forward appeal documents and requests from providers and MACs, ensuring federal, state, and company compliance. Process all documents efficiently, upload media to accounts, and distribute designated files to internal departments. Meet daily and weekly production standards while providing management recommendations for workflow improvements. Complete assigned tasks accurately and independently, maintaining high-quality work under strict deadlines. Collaborate with multi-location teams to solve problems and streamline processes.
Required Qualifications
- High School diploma or GED
- 5+ years in relevant office/administrative/support environment roles with progressive complexity, preferably in healthcare-related business
- Demonstrated knowledge of healthcare audit, appeals processes, claim processing, billing, and recovery processes and practices
- Medicare and Medicaid working knowledge
- Intermediate MS Excel and MS Word skills
- Strong knowledge of medical documentation
- High level of ability in multi-tasking and prioritizing workload
- Must have flexibility and be able to adapt to ever-changing needs and requirements
- Able to meet or exceed deadlines
- Ability to maintain high quality of work while meeting strict deadlines
- Able to work efficiently, independently, and complete any/all workload as assigned by department management
- Strong communication in both verbal and written business language skills
- Courteous, professional, and respectful attitude
- Responsible, dependable, conscientious, detail-oriented, and reliable
Desired Qualifications
- Medicare and Medicaid working knowledge strongly preferred
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