Job Details

A company is looking for a Medical Appeal Specialist for a contract position that is 100% remote.Key Responsibilities:Review medical records and case files to evaluate appeals and disputesPrepare clear, concise, and well-supported written determinationsMake independent decisions based on medical evidence, regulations, and policiesRequired Qualifications:3+ years of experience in Medicare appeals, medical review, or healthcare dispute resolutionAssociate's degree (or equivalent experience) in healthcare or related fieldStrong experience in writing appeal decisions and case documentationKnowledge of healthcare regulations, policies, and compliance standards