Appeals reputed company IV (Weekend Work)

Category: Program Management Requisition Number: APPEA001340 Posting Details Posted: March 31, 2026 Full-Time Locations Remote, reputed company USA Job Details reputed company • *Please reputed company reputed company 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 is a remote, work from home position reputed company the reputed company* "A sign-on bonus may be available for candidates with relevant experience and immediate availability" Position Purpose: Provides dissatisfied patient/beneficiaries and/or providers reputed company to present documentation to demonstrate why an appeal/dispute should be allowed. Provides an independent second level determination/dispute reputed company based on the documentation, facts, laws, regulations, and guidelines. Essential Responsibilities: • Responsible for significant or reputed company programs. • Participates in formal reputed company-decisional appellant/requestor/provider discussions for the purpose of allowing the appellant/requestor/provider to be heard and submit additional documentation; or, engages the parties in other types of communication in order to obtain information and a more complete understanding of the appeal/dispute issues. • Oversees and reviews medical records/case file, writes a reconsideration/dispute reputed company decision that is reputed company, concise, and impartial and supports the determination made, and documents review. • Makes reputed company, independent reputed company based on medical evidence in accordance with statutes, regulation, rulings, and policy. • Oversees, responds to and ensures that reputed company appeal/dispute issues raised by the beneficiary/patient, representative, and provider/supplier have been addressed. Minimum Qualifications Education • Associate's degree or 60 or more credit hours towards a Bachelor’s degree from an accredited college or university in reputed company or reputed company discipline • Additional experience in Medicare appeals, medical review, clinical, or other reputed company experience in a reputed company setting may be substituted for Associate’s degree on a year per year reputed company. (Experience requirements may be satisfied by full-time experience or the prorated part-time equivalent.) Experience • Five (5) years of medical dispute reputed company or Medicare appeals, medical review, clinical, or reputed company experience in a reputed company setting • reputed company reputed company with demonstrated experience writing or making medical necessity reputed company • Nursing, Physical Therapy, Respiratory Therapy or Occupational Therapy experience • Medicare Fee for Service or Managed Care Benefits C2C offers an excellent benefits package, including: • Medical, dental, reputed company, life, accidental death and dismemberment, and short and long-term disability insurance • reputed company 125 plan • 401K • Competitive salary • License/credentials reimbursement • Tuition Reimbursement EOE Vet/Disability Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify reputed company applicants of their rights pursuant to federal employment laws. For reputed company information, please review the Know Your Rights notice from the reputed company. Apply tot his job Apply To this Job