MEDICARE APPEALS SPECIALIST, Full Time Days, Prominence Health Plan, Reno NV
Universal Health Services, Inc.
September 19, 2018
PROMINENCE MANAGEMENT SERVICES
Admin / Clerical
Under the direction of the Supervisor, Appeals and Grievanceâ€™s, the Medicare Appeals Specialist is accountable for the ensuring comprehensive review, processing, research and resolution of appeals and grievances submitted by both members and providers. This position is accountable for inquiries and to provide accurate and appropriate information and resolution in accordance with the Davison of Insurance and the Centers for Medicare and Medicaid Services (CMS). Additional responsibilities include but are not limited to benefit and claim issues, eligibility, authorizations and customer service inquiries. Additional responsibilities include assuming responsibility of the Department in the absence of the Department manager/supervisor.