Remote Medicare Appeals Intake Specialist

A-Line; Detroit (MI); Remote; USD 25,000 - 28,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Life insurance

Short-term disability after 90 days

Job summary

A-Line is seeking a Remote Appeals Coordinator to support processing of Medicare member and provider appeals and grievances. The role screens for urgency, benefit coverage, and medical necessity, routing cases to the appropriate analyst.

Responsibilities include investigations, documentation gathering, correspondence, and periodic auditing or monitoring activities, collaborating with Customer Service, Utilization Management, Medical Directors, and other teams to ensure compliant intake and

Qualifications

• High School Diploma-Required
• Minimum 1 year in health insurance or managed care performing Appeals and Grievances functions - Required
• HealthEdge, Epic, and or Facets experience preferred

Responsibilities

• The Appeals Intake Coordinator supports the processing of incoming Medicare member and provider appeals and grievances.
• This role screens and triages incoming complaints for urgency, benefit coverage, and medical necessity concerns, then routes cases to the appropriate analyst.
• The coordinator may assist with investigations, documentation gathering, correspondence, and periodic auditing or monitoring activities.
• Partners closely with Customer Service, Utilization Management, Medical Directors, and other internal teams to ensure timely and compliant handling of appeal and grievance intake.

Skills

Appeals & Grievances processes

Education

High School Diploma

Tools

HealthEdge

Epic

Facets

Job description

A-Line is seeking a Remote Appeals Coordinator to support processing of Medicare member and provider appeals and grievances. The role screens for urgency, benefit coverage, and medical necessity, routing cases to the appropriate analyst.

Responsibilities include investigations, documentation gathering, correspondence, and periodic auditing or monitoring activities, collaborating with Customer Service, Utilization Management, Medical Directors, and other teams to ensure compliant intake and