[Hiring] Medicare Appeals Assistant @Mass General Brigham

Role Description

Responsible for supporting the Medicare appeals and claims resolution process, ensuring timely submission and follow-up on appeals. Assists with gathering documentation, tracking case statuses, and coordinating communications between departments to ensure the accurate handling of claims. The ideal candidates can distinguish an inquiry, coverage request, appeal, claims dispute, and grievance to tirage, which means being able to identify what an expedited request is. The ideal candidate has experience in QNXT and Epic.

• Prepares and submits appeal documents and claims-related materials to insurance providers and other stakeholders.
• Maintains organized records of all appeals and claim-related communications and case statuses.
• Coordinates with billing and claims teams to ensure proper documentation for appeals.
• Assists with follow-up on pending appeals and communicates status updates to relevant parties.
• Supports the preparation of reports on appeals activity, trends, and outcomes.
• Handles correspondence related to appeals, including letters, forms, and supporting documentation.
• Monitors appeal deadlines and ensures timely submission and follow-up.
• Provides administrative support to the billing/claims team and other departments as needed.

Qualifications

• High School Diploma or Equivalent required.
• At least 1-2 years of appeals and grievances experience required.
• Medicare appeals/grievances is highly preferred.
• At least 1-2 years of claims setting preferred.
• Proficient organizational and time-management skills.
• Effective written and verbal communication abilities.
• Proficient in Microsoft Office and other billing software.
• Attention to detail and accuracy in document preparation.
• Ability to handle multiple tasks and work efficiently in a fast-paced environment.

Requirements

• This is a remote role with a Monday through Friday, 8:30 AM to 5:00 PM schedule.
• Scheduled Weekly Hours: 40.
• Employee Type: Regular.
• Work Shift: Day (United States of America).
• Pay Range: $19.81 - $28.30/Hourly.
• Grade: 3.

Benefits

• Competitive salaries.
• Flexible work options.
• Career growth opportunities.
• Comprehensive benefits package.
• Recognition programs designed to celebrate contributions and support professional growth.