Reconsideration Analyst II
TMF Group · Austin, Texas, US
**Please make sure your application is complete, including your education, employment history, and any other applicable sections. Initial screening is based...
Job description
**Please make sure your application is complete, including your education, employment history, and any other applicable sections. Initial screening is based on the minimum requirements as defined in the job posting, such as education, experience, licenses, and certifications. Your experience should also address the knowledge, skills and abilities needed for the role. Incomplete applications will not be considered.** *This position is located Remote United States* Position Purpose: Conducts second level non-medical Medicare appeals decisions , including review of appeal cases dismissed by the level 1 contractor. Essential Responsibilities: - Writes a non-medical reconsideration decision that is clear and supports the determination made. - Ensures that all appeal issues raised by the party (e.g., enrollee, representative, ornon-contract provider) have been addressed. - Provides a fair and impartial decision based on current evidence, regulations, policies, and procedures. - Ensures all documents are releasable and do not violate any Privacy Act provisions. - Organizes documents by dates of service relevant to the charges, research denials and regulations used by the contract and ensu...