ML
Appeals Support Specialist
full-time•California
About this role
Position Summary
The Appeals Support Specialist supports the appeals workflow by reviewing submissions, responding to client inquiries, escalating urgent issues, requests dismissals as well as case updates from outside counsel, runs reports as needed, negotiates settlements, verifies required documentation, and ensures cases are accurately logged for processing. This role supports timely resolution of appeals and assists with general administrative and reporting tasks.
Key Responsibilities
- Review, enter, respond, and track appeal requests.
- Validate required documentation and request missing information when necessary.
- Maintain organized and accurate records of appeal activities.
- Maintain required Turn Around Time (TAT) per client contracts and state regulations.
- Support IQA Appeals specialist with tasks and process improvements.
Qualifications
- High school diploma required; related post-secondary education preferred.
- Experience in appeals, claims, or healthcare operations
is a plus. - Strong attention to detail, organization, and written communication.
- Proficiency with Microsoft Office tools.
What you'll do
- The Appeals Support Specialist supports the appeals workflow by reviewing submissions, responding to client inquiries, escalating urgent issues, and managing case updates from outside counsel. This role ensures timely resolution of appeals while assisting with general administrative and reporting tasks.
About MedRisk LLC
Founded in 1994 and headquartered in Conshohocken, Pennsylvania, MedRisk was established with a mission to revolutionize physical rehabilitation for workers' compensation patients. Over the last 30 years, the company has evolved into a leading managed care organization dedicated to physical rehabilitation and medical bill review for the casualty claims industry.
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Frequently Asked Questions
What does a Appeals Support Specialist do at MedRisk LLC?
As a Appeals Support Specialist at MedRisk LLC, you will: the Appeals Support Specialist supports the appeals workflow by reviewing submissions, responding to client inquiries, escalating urgent issues, and managing case updates from outside counsel. This role ensures timely resolution of appeals while assisting with general administrative and reporting tasks..
Is the Appeals Support Specialist position at MedRisk LLC remote?
The Appeals Support Specialist position at MedRisk LLC is based in California, United States. Contact the company through Clera for specific work arrangement details.
How do I apply for the Appeals Support Specialist position at MedRisk LLC?
You can apply for the Appeals Support Specialist position at MedRisk LLC directly through Clera. Click the "Apply Now" button above to start your application. Clera's AI-powered platform will help match your profile with this opportunity and guide you through the application process.