Remote Medicare Grievances & Appeals Coordinator

Randstad USA; Fort Lauderdale (FL); À distance; USD 31 000 - 32 000; Plein temps

Résumé du poste

Randstad USA in Fort Lauderdale is seeking a Medicare Appeals Coordinator to own retrospective authorization appeals and high-priority escalated cases. You will navigate complex claims histories, collaborate with Clinical, Intake/Triage, Claims, and leadership to drive audit-ready, compliant outcomes.

The ideal candidate has 2+ years in Medicare grievance and appeals processing, strong attention to detail, and the ability to manage high-volume inventories while meeting tight deadlines.

Qualifications

• 2+ years in Grievance and Appeals within healthcare or managed care.
• Proven Medicare appeals regulations knowledge and case processing.
• Strong analytical, detail-oriented, and deadline-driven mindset.

Responsabilités

• Investigate and resolve retrospective authorization appeals and escalated Medicare cases per guidelines.
• Research documentation and claims history across internal systems for compliant resolutions.
• Collaborate with Clinical, Intake/Triage, Claims, and leadership to coordinate outcomes.
• Maintain audit-ready records and track daily inventory to avoid aging cases.
• Identify bottlenecks and drive continuous process improvements.

Connaissances

Medicare Appeals

Analytical Research

Inventory Management

Formation

High School

Description du poste

Randstad USA in Fort Lauderdale is seeking a Medicare Appeals Coordinator to own retrospective authorization appeals and high-priority escalated cases. You will navigate complex claims histories, collaborate with Clinical, Intake/Triage, Claims, and leadership to drive audit-ready, compliant outcomes.

The ideal candidate has 2+ years in Medicare grievance and appeals processing, strong attention to detail, and the ability to manage high-volume inventories while meeting tight deadlines.