Reconsideration Analyst III (Weekend Work)
*This position is working weekends*
**Please make sure your application is complete, including your education, employment history, and any other applicable sections. Initial screening is based on the minimum requirements as defined in the job posting, such as education, experience, licenses, and certifications. Your experience should also address the knowledge, skills and abilities needed for the role. Incomplete applications will not be considered.**
*This position is located Remote United States*
Position Purpose:
Makes second level non-medical appeal decisions. This may include review of appeal cases dismissed by the level 1 contractor or Expedited appeals.
Essential Responsibilities:
Writes a non-medical reconsideration decision that is clear and supports the determination
Ensures that all appeal issues raised by the party (e.g., enrollee, representative, or non-contract provider) have been
Provides a fair and impartial decision based on current evidence, regulations, policies, and
Ensures all documents are releasable and do not violate any Privacy Act
Organizes documents by dates of service relevant to the charges, research denials and regulations used and ensure that any overpayment calculation is correct.
Minimum Qualifications
Education
High School Diploma or equivalent
Experience
Three (3) years of general office experience
College education or technical training in administration, business, or related areas may be substituted for experience on a year per year (Education requirements may be satisfied by full-time education or the prorated part-time equivalent.)
Two (2) years high volume of customer calls, appeals, or billing
Experience directly relevant to Medicare managed care appeals or utilization management activities, preferred
Benefits
C2C offers an excellent benefits package, including:
Medical, dental, vision, life, accidental death and dismemberment, and short and long-term disability insurance
Section 125 plan
401K
Competitive salary
License/credentials reimbursement
Tuition Reimbursement
EOE Vet/Disability
Apply Now
**Please make sure your application is complete, including your education, employment history, and any other applicable sections. Initial screening is based on the minimum requirements as defined in the job posting, such as education, experience, licenses, and certifications. Your experience should also address the knowledge, skills and abilities needed for the role. Incomplete applications will not be considered.**
*This position is located Remote United States*
Position Purpose:
Makes second level non-medical appeal decisions. This may include review of appeal cases dismissed by the level 1 contractor or Expedited appeals.
Essential Responsibilities:
Writes a non-medical reconsideration decision that is clear and supports the determination
Ensures that all appeal issues raised by the party (e.g., enrollee, representative, or non-contract provider) have been
Provides a fair and impartial decision based on current evidence, regulations, policies, and
Ensures all documents are releasable and do not violate any Privacy Act
Organizes documents by dates of service relevant to the charges, research denials and regulations used and ensure that any overpayment calculation is correct.
Minimum Qualifications
Education
High School Diploma or equivalent
Experience
Three (3) years of general office experience
College education or technical training in administration, business, or related areas may be substituted for experience on a year per year (Education requirements may be satisfied by full-time education or the prorated part-time equivalent.)
Two (2) years high volume of customer calls, appeals, or billing
Experience directly relevant to Medicare managed care appeals or utilization management activities, preferred
Benefits
C2C offers an excellent benefits package, including:
Medical, dental, vision, life, accidental death and dismemberment, and short and long-term disability insurance
Section 125 plan
401K
Competitive salary
License/credentials reimbursement
Tuition Reimbursement
EOE Vet/Disability
Apply Now