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Appeals Senior Associate

  • Location

    Bedford, United States

  • Sector:

    Other Area(s)

  • Job type:

    Contract

  • Contact:

    Leric Arcigal

  • Job ref:

    19034

  • Published:

    over 1 year ago

  • Expiry date:

    2020-02-29

  • Same manager as req #9007545. Please do not submit candidates already submitted to req #9007545 unless instructed to by MSP*

Appeal/Dispute project regarding recoupments for our EVV regulatory requirements not being met.

Updates appeal/dispute tracking system.

Consults with Appeals Leadership regarding technical claims issues.

Determines required expert resources at each juncture and solicits input.

Based on appeal/dispute investigation, determines whether claim is reconsidered or original denial was appropriate.

Proactively communicated with claimants,providers and leadership to resolve investigation issues and communicate decisions/rationale for denial/approval.