Solventum is hiring an Appeals Specialist II to evaluate denied Medicare primary insurance claims and appeal them through various legal processes. Guided by empathy, insight, and clinical intelligence, you'll collaborate with the best minds in healthcare to address our customers’ toughest challenges.
What You'll Do
- Evaluate denied Medicare primary insurance claims in a timely manner.
- Appeal denied claims through Redetermination, Reconsideration, or the Administrative Law Judge process in accordance with State and Federal laws.
- Proactively investigate and analyze patient charts by reading documents and performing computer-based research.
- Research and concisely summarize findings in medical records, documenting where appropriate.
- Independently recognize issues, problems, and trends with the ability to communicate findings to management.
What We're Looking For
- High School Diploma or GED.
- Five (5) years of experience in medical billing or collections process experience in a private, public, government, or military environment.
- Must be legally authorized to work in the country of employment without sponsorship for employment visa status (e.g., H1B status).
Nice to Have
- Proficient communication and data entry skills.
- Medical Records experience.
- Demonstrated ability to work effectively and exercise sound business judgment in a team environment and independently.
- Ability to communicate proficiently, both verbally and in writing, with internal and external customers.
- Consistency in meeting deadlines and maintaining production and quality levels as established by management.
- Excellent accounting skills.
- Proficient Microsoft Office skills.
Benefits & Compensation
- Compensation range: $46,377 - $56,684.
Work Mode
This position is remote and open to candidates located in the United States.
Solventum is an equal opportunity employer. Solventum will not discriminate against any applicant for employment on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or veteran status.
