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Appeals Support Specialist at MedRisk LLC

, California, United States -

Full Time

Start Date

Immediate

Expiry Date

28 Apr, 26

Salary

0.0

Posted On

28 Jan, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Reviewing Submissions, Client Inquiry Response, Issue Escalation, Dismissal Requests, Case Updates, Reporting, Settlement Negotiation, Documentation Verification, Case Logging, Turn Around Time (TAT) Maintenance, Process Improvement, Attention To Detail, Organization, Written Communication, Microsoft Office Proficiency

Industry

Hospitals and Health Care

Description

Position Summary The Appeals Support Specialist supports the appeals workflow by reviewing submissions, responding to client inquiries, escalating urgent issues, requests dismissals as well as case updates from outside counsel, runs reports as needed, negotiates settlements, verifies required documentation, and ensures cases are accurately logged for processing. This role supports timely resolution of appeals and assists with general administrative and reporting tasks. Key Responsibilities * Review, enter, respond, and track appeal requests. * Validate required documentation and request missing information when necessary. * Maintain organized and accurate records of appeal activities. * Maintain required Turn Around Time (TAT) per client contracts and state regulations. * Support IQA Appeals specialist with tasks and process improvements. Qualifications * High school diploma required; related post-secondary education preferred. * Experience in appeals, claims, or healthcare operations is a plus. * Strong attention to detail, organization, and written communication. * Proficiency with Microsoft Office tools.

Responsibilities

The Appeals Support Specialist supports the appeals workflow by reviewing submissions, responding to client inquiries, escalating urgent issues, and managing case updates from outside counsel. This role ensures timely resolution of appeals while assisting with general administrative and reporting tasks.