What are the responsibilities and job description for the Medicare Appeals Specialist position at Lympha Press?
Ranked by Fortune Magazine Great Place to Work as Best Small Business Healthcare Workplace in the USA for 2018 and 2019 and by Philly.com for the last 9 consecutive years as a top work place! Since 1994, Lympha Presshas specialized in home therapy equipment and supplies to treat chronic or acute medical conditions. Our nationwide medical sales and support staff works closely with doctors, nurses, physician assistants, therapists, case managers and their patients to achieve the best possible results.
LymphaPress, an industry-leading and award-winning organization specializing in home compression therapy products, has an excellent opportunity to join our team as a Medicare Appeals Specialist focused on reviewing and submitting claims for Medicare appeals.
This role will be responsible for the following:
- 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.
Professional and Educational Requirements:
- The hours for this position are 8:30 am - 5:00 pm; occasionally an adjusted work schedule is required to accommodate company needs.
- GED or High School Diploma required, plus 2-3 years of related work experience and/or training.
- Must be able to work in a fast-paced environment.
- Strong communication skills - both verbal and written.
- Must demonstrate good organization and time management skills.
- Knowledge of computers and software programs applicable to the industry.
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.
Serving patients nationally, we are committed to making a difference in the lives of those we serve by putting our core values (SCRIP) into action through:
- Solving problems
- Being Courageously kind
- Redefining possibilities through quality
- Inspiring others
- Putting people first
If you're seeking an organization with a great culture, we have much to offer! We are honored to be certified as a Great Place to Work and to be recognized by Philly Top Workplaces and Fortune Magazine as a top employer in our industry! We offer a competitive compensation and benefits package. Apply today to become a valued member of our growing team!
AAP/EOE/Disability/Veterans
Salary : $26 - $31
