Industry - Industry
Location - Work From Home
Duration - Over 5 months
Position - Appeals Processing Senior Representative
Working Hours - M-F 8-5
***Looking soeone with 3 Years’ experience Medicare Part C related to Appeals, Claims or Grievances***
***This is 100% Remote position***
conduct review of all new member and provider correspondence by analyzing all the issues presented to determine appropriate classification
Validate all assigned cases; review appeal documents, correct appeal types, timeframes and what is being appeals
Requires effective communication abilities (written and verbal) when documenting actions and communications with Members, Providers, Medical Director and appeals leadership.
Responsible for maintaining and prioritizing work load to support appeal timeliness and communicate risks, concerns or opportunities to leadership related to their work load
Assist the Manager/Supervisor in identifying root cause issues related to appeals
Requires 3 Years’ experience Medicare Part C related to Appeals, Claims or Grievances
Working knowledge of Medicare Advantage appeal regulations
Requires more than 3 years’ experience in Medicare to include appeals, billing, claims, customer service or health insurance;
Knowledge of medical terminology and coding
High school Diploma
Why Work Here?Not only is Collabera committed to meeting and exceeding our customer’s needs, but we also are committed to our employees’ satisfaction as well. We believe our employees are the cornerstone of our success and we make every effort to ensure their satisfaction throughout their tenure with Collabera. We offer an enriching experience that promotes career growth and lifelong learning for our employees. As a result of these efforts, we have been recognized by Staffing Industry Analysts (SIA) as one of the “Best Staffing Firms to Work For” since 2012 – eight consecutive years in a row. Collabera has 60 offices with a presence in 11 countries and provides staff augmentation, managed services and direct placement services to Fortune 500 corporations across the globe.
Collabera has been recognized by Staffing Industry Analysts (SIA) as one of the “Best Staffing Firms to Work For” for 8 consecutive years.