Healthcare Appeals Specialist - Beaumont Texas

Company: VirtualVocations
Location: Beaumont, Texas
Posted On: 11/20/2024

A company is looking for an Appeals Professional (Healthcare Professional) to perform complex work related to medical dispute resolution.



Key Responsibilities

Review medical records and write clear, concise, and impartial reconsideration decisions
Make independent decisions based on medical evidence, regulations, and policies
Conduct research to support accurate and well-informed decisions


Required Qualifications

Associate's degree or 60+ credit hours towards a Bachelor's degree in healthcare or related discipline
Three years of experience in medical dispute resolution or related healthcare settings
Experience in writing or making medical necessity decisions
Experience in nursing, physical therapy, respiratory therapy, or occupational therapy
Medicare and appeals experience preferred More...

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