Overview
Remote
Depends on Experience
Contract - Independent
Skills
Appeals
Rebuttals
CMS
Job Details
Position Duties:
- Acts as internal consultant by providing guidance and support to assist Appeals specialist, Project Manager, and QA Manager in the development of written decisions on the Appeal or Rebuttal.
- Provides high quality customer service to all providers/suppliers/properly appointed representatives as it relates to the submission, processing, and issuance of decisions for rebuttals, CAPs, and reconsideration requests.
- Understands and properly uses and interprets various federal policies, regulations, and systems in response to providers that are challenging provider enrollment administrative actions rendered by CMS.
- Follows all detailed instructions when receiving, processing, and rendering written decisions.
- Participates actively in business decision-making by offering qualitative feedback, recommendations, and discussing what-if scenarios.
- Influences and analyzes time sensitive case responses.
- Coaches, supports, and cross-trains with peers. Inputs case details in the requisite systems.
- Opportunities for travel may arise occasionally for in-person meetings, trainings, and presentations.
Education and Experience Requirements:
- Possess either: (1) a 4-year degree from an accredited institution (i.e., a Bachelor s degree) with at least 3 year of experience in healthcare regulatory interpretation/application and/or in healthcare compliance, or (2) a Paralegal Certificate from an accredited institution with at least 3 year of experience working as a Paralegal.
- Excellent command of English language writing; syntax, grammar and punctuation
- Legal writing experience is preferred
- Proficiency in the use of case management systems and word processing software
- Ability to adhere delivery timelines
"C-HIT is an EOE, including disability and veterans."