This is a fully remote position, open to applicants in Florida, +4 more states.

📋 Description

• Assist in the documentation and processing of appeals, disputes, and reconsiderations.

• Execute data entry for tracking, logging, and processing cases.

• Draft correspondence and manage documentation files.

• Examine and investigate requests to identify necessary follow-up actions.

• Conduct research to assess, process, and respond to cases in a timely manner.

• Compile case files with supporting documentation and conclusions.

• Collect data to monitor and report on trends and final outcomes.

• Engage in outreach for status updates, determinations, and clarifications.

• Undertake additional duties as assigned.

• Adhere to all policies and standards.

⛳️ Requirements

• Must possess authorization to work in the U.S. without requiring employment-based visa sponsorship now or in the future.

• A High School diploma or GED is required.

• 1–2 years of relevant experience is required.

• Familiarity with the appeals, disputes, and reconsiderations process is preferred.

• Experience with No Surprises Act (NSA) Open Negotiation Requests (ONRs), Independent Dispute Resolution (IDR), and/or state healthcare payment disputes is preferred.

• Capability to perform data entry, documentation, research, case-file preparation, tracking, and reporting related to appeals, disputes, and reconsiderations.

• Must adhere to all policies, standards, regulatory requirements, and accreditation guidelines.