Appeals Specialist

***Must live in  CO, FL, GA, IA, IN, MI, MO, NE, NC, NJ, NY, OH, PA, SC, TN, TX, UT, VA***

We are currently seeking a part time Physician Appeal Specialist to join our Denials department.

This role is pivotal in our organization, as it involves reviewing medical records, handling clinical inpatient appeals, and ensuring that our appeals are submitted in compliance with payer requirements.

Job Duties as a Physician Appeal Specialist, you would be responsible for:

• Reviewing medical records to determine the medical necessity of various clinical denials. Identifying the specific parts and pages of medical records required for submission to payers.
• Crafting well-reasoned appeals and completing necessary payer forms. Ensuring the timely submission of appeals at both the first and second levels.

To excel in this role, we are looking for candidates who possess the following qualifications:

• Certified MD (active or non-practicing)
• Proficiency in Microsoft Word, Adobe PDF, Excel, Outlook, to efficiently handle daily job duties.

At Revco Solutions, we are proud to offer a comprehensive benefits package, which includes:

• Medical, dental, and vision coverage to keep you and your family healthy.
• Generous paid time off (PTO) to help you maintain a healthy work-life balance.
• Paid holidays to celebrate and spend quality time with loved ones.
• A 401(k) retirement savings plan to help you secure your financial future.

This role not only allows you to leverage your medical expertise but also offers a unique opportunity to contribute to our mission of ensuring that healthcare services are delivered and reimbursed correctly. So, if you are interested in joining our dynamic team at REVCO Solutions and believe you have the qualifications we are seeking, please apply today!

• Certified MD (active or non-practicing)
• Proficiency in Microsoft Word, Adobe PDF, Excel, Outlook, to efficiently handle daily job duties.