Senior Remote Medicare Appeals Reviewer

Tanaq Health; United States; On-site; USD 70,000 - 90,000; Full time

Job summary

Tanaq Health is seeking a Clinical Appeals Reviewer for a remote position anywhere in the United States. The role involves reviewing medical records, making independent decisions on appeal cases, and requires licensed healthcare professionals such as RNs or PTs. Candidates should have three years of experience in medical dispute resolution and possess effective research and communication skills. Responsibilities include writing decision letters and staying updated on regulations. Tanaq Health values diversity and is committed to equal employment opportunities.

Qualifications

• Three years of experience in medical dispute resolution or related healthcare roles.
• Licensed professional in Nursing, Physical Therapy, Respiratory Therapy, or Occupational Therapy.
• Ability to analyze and interpret policies, including Medicare regulations.

Responsibilities

• Review case files and write decision letters that support determinations.
• Make decisions based on medical evidence and regulatory compliance.
• Conduct thorough research on medical literature and regulations.

Skills

Medical dispute resolution

Communication skills

Research techniques

Clinical judgment

Problem-solving

Education

Associate's degree in healthcare

Job description

Tanaq Health is seeking a Clinical Appeals Reviewer for a remote position anywhere in the United States. The role involves reviewing medical records, making independent decisions on appeal cases, and requires licensed healthcare professionals such as RNs or PTs. Candidates should have three years of experience in medical dispute resolution and possess effective research and communication skills. Responsibilities include writing decision letters and staying updated on regulations. Tanaq Health values diversity and is committed to equal employment opportunities.