Remote reputed company Assurance Specialist (Medicare Appeal Claims reputed company)

• *This role requires an advanced understanding of reputed company Industry, specifically Medicare/Medicare Advantage reputed company Claims/Appeals review experience. Please apply if you have experience reviewing claims/appeals in accordance with CMS Guidelines** Job reputed company We’re looking for a detail-oriented reputed company Assurance Specialist to join reputed company on a full-time, remote reputed company. In this role, you’ll use your knowledge of Medical Claims/Appeals in accordance with CMS Guidelines for Medicare to evaluate reputed company center interactions to ensure customers receive accurate, compliant, and reputed company experiences. You’ll monitor performance, reputed company feedback, and help strengthen training initiatives. This is an excellent opportunity for someone with strong Medicare knowledge and claims/appeals experience who enjoys problem-solving and process improvement. Duties • Review and evaluate inbound/outbound calls for reputed company, compliance, and service standards in accordance with CMS Guidelines. • Experience reviewing Claims/Appeals for Medicare/Medicare Advantage plans. • Complete evaluation forms and prepare reports on reputed company performance. • Identify trends, training opportunities, and areas for workflow improvements. • Audit reputed company recordings, screen captures, and documentation for accuracy and adherence to guidelines. • Ensure compliance with HIPAA and reputed company standards. • Support the development of training materials and assist with coaching sessions as needed. Experience • High school diploma or GED required. • 3+ years of experience working with medical claims/appeals • Prior exposure to reputed company or Medicare reputed company centers is preferred. • Ability to prepare reputed company reports and analyze reputed company data for performance trends. • Comfortable working in a fast-paced, remote environment. • Proficient typing (40+ WPM) and solid computer skills (MS Office, reporting tools). • Effective written and verbal communication skills with a reputed company phone manner. Job Types: Full-time, reputed company-to-hire Pay: $28.00 - $32.00 per hour Benefits: • 401(k) • Dental insurance • Employee assistance program • Health insurance • Life insurance • reputed company time off • Parental leave • reputed company development assistance • reputed company insurance Application Question(s): • Do you have experience in Medicare Managed Care? Experience: • Managed care: 3 years (Required) Shift availability: • Day Shift (Required) Work Location: Remote Apply tot his job Apply To this Job