Demo

Medicare Appeals Specialist

Hueman PE Talent Solutions
Chadds Ford, PA Full Time
POSTED ON 1/23/2025
AVAILABLE BEFORE 4/22/2025

Description

Lympha Press is hiring a Medicare Appeals Specialist as a full-time job in Chadds Ford, PA.

As a Medicare Appeals Specialist, you will review Medicare denial notices, review patient cases, gather all documentation and submit claims needed for Medicare appeals. You will also assist with all aspects of the Appeals process.

Lympha Press is an industry-leading and award-winning organization specializing in home compression therapy products.

Key Responsibilities :

  • Review Medicare Claim Denials.
  • Review patient records for accuracy and completeness.
  • Review / Audit claims, prepare and submit audit claims for all levels of review up to and including ALJ hearings.
  • Maintain Audit sheets in accordance with Company procedures.
  • Update company patient database (MSS) on all case activity.
  • Deliver feedback to Team Leader on status of Appeals, Denials, and areas of suggested improvement.
  • Prepare and submit all aspects of Medicare RAC, TPE, and CERT reviews and audits.
  • Assists with related special projects, as required.
  • Works effectively with other company employees, managers, and departments.
  • Performs all job functions with Company Mission, Vision, and Goal Statements in mind.

Job Qualifications :

  • High school diploma or GED required; 2-3 years of relevant industry experience or equivalent combination of education and experience preferred. No specific certification or licensure required but preferred.
  • Proficiency in basic to intermediate mathematical concepts (fractions, percentages, ratios, and statistical inference) to support job functions.
  • Proficient in computers and industry-relevant software, including word processing, spreadsheets, and database management. Ability to learn company-specific software quickly.
  • Strong analytical skills with the ability to interpret complex data and produce logical solutions where limited guidance exists.
  • Strong interpersonal and communication skills with the ability to read and interpret business and technical information, write reports and procedures, and communicate effectively across the organization.
  • Able to work in a standard office setting using standard equipment. Requires sustained attention to detail, stamina to sit for extended periods, and manual dexterity for various office tasks.
  • Able to maintain productivity and judgment in a fast-paced environment with occasional schedule adjustments as needed.
  • Ability to work independently, manage time effectively, and handle interruptions with professionalism.
  • For over 40 years, Lympha Press has produced the most well-regarded dynamic compression therapy systems and helped patients all over the world with lymphedema, venous insufficiency, and lipedema manage their condition and improve their quality of life. We are always looking for hard-working, honest people who are motivated to succeed and willing to learn. Lympha Press is honored to be a certified Great Place to Work and recognized as a top employer by Philly Top Workplaces and Fortune Magazine.

    If you are interested in learning more about a career with Lympha Press as a Medicare Appeals Specialist apply today!

    AA / EOE / Vets / Disabled

    INDPE2023

    Pay Range

    26.00 Hourly to $31.00 Hourly

    Salary : $31

    If your compensation planning software is too rigid to deploy winning incentive strategies, it’s time to find an adaptable solution. Compensation Planning
    Enhance your organization's compensation strategy with salary data sets that HR and team managers can use to pay your staff right. Surveys & Data Sets

    What is the career path for a Medicare Appeals Specialist?

    Sign up to receive alerts about other jobs on the Medicare Appeals Specialist career path by checking the boxes next to the positions that interest you.
    Income Estimation: 
    $48,731 - $60,363
    Income Estimation: 
    $55,490 - $70,607
    Income Estimation: 
    $49,313 - $64,855
    Income Estimation: 
    $49,126 - $60,591
    Income Estimation: 
    $48,731 - $60,363
    Income Estimation: 
    $55,490 - $70,607
    Income Estimation: 
    $49,313 - $64,855
    Income Estimation: 
    $49,126 - $60,591
    Income Estimation: 
    $38,612 - $46,691
    Income Estimation: 
    $48,731 - $60,363
    Income Estimation: 
    $43,963 - $55,591
    Income Estimation: 
    $44,557 - $53,909
    Income Estimation: 
    $87,788 - $104,837
    Income Estimation: 
    $70,647 - $86,374
    Income Estimation: 
    $123,613 - $165,638
    Income Estimation: 
    $69,116 - $84,792
    Income Estimation: 
    $55,490 - $70,607
    Income Estimation: 
    $70,647 - $86,374
    Income Estimation: 
    $123,613 - $165,638
    Income Estimation: 
    $69,116 - $84,792
    View Core, Job Family, and Industry Job Skills and Competency Data for more than 15,000 Job Titles Skills Library

    Job openings at Hueman PE Talent Solutions

    Hueman PE Talent Solutions
    Hired Organization Address Tulsa, OK Full Time
    The Service Manager is responsible for overseeing the day-to-day operations of the service department, ensuring efficien...
    Hueman PE Talent Solutions
    Hired Organization Address Greenville, SC Full Time
    Scout Land Consultants is searching for a Land Acquisition Manager (“LAM”) located in or around Greenville, SC. As the L...
    Hueman PE Talent Solutions
    Hired Organization Address Bradenton, FL Full Time
    Our confidential client is hiring a Full-Time Executive/ Personal Assistant in Bradenton, FL. Job Title: Executive/Perso...
    Hueman PE Talent Solutions
    Hired Organization Address Azusa, CA Full Time
    Job Description Job Description Alliance Environmental Group is hiring for an experienced Sr. Director of Financial Plan...

    Not the job you're looking for? Here are some other Medicare Appeals Specialist jobs in the Chadds Ford, PA area that may be a better fit.

    Medicare Appeals Specialist

    Lympha Press, Chadds Ford, PA

    Medicare Specialist

    AMERICAN SENIOR BENEFITS LLC, Wilmington, DE

    AI Assistant is available now!

    Feel free to start your new journey!