Appeals Specialist – CGS Admin

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🔥 1 hour ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

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CGS Administrators, LLC

WebsiteLinkedInAll Job Openings

501 - 1000 employees

⚕️ Healthcare Insurance

🤝 B2B

Healthcare Insurance • B2B • Fraud Prevention

CGS Administrators, LLC is a company that provides scalable administrative services focused on optimizing operational performance and reducing costs for health plans. With over 50 years of experience, CGS delivers a range of services including credentialing, member services, claims processing, and fraud prevention to the Centers for Medicare & Medicaid Services (CMS) and various healthcare providers. Their aim is to streamline operations and enhance customer satisfaction, contributing positively to the healthcare delivery system.

📋 Description

• Performs non-medical reviews and processes redetermination letters ensuring timeliness and accuracy. • Prepares unit reports, analyzes and interprets workload, and processes issues utilizing various software tools. • Updates letters and documents within the department when necessary. • May gather and prepare documentation for legal inquiries and administrative requests.

🎯 Requirements

• Required Education: High School Diploma or equivalent • Required Work Experience: 2 years job related field. • Required Skills and Abilities: Demonstrated proficiency in word processing and spreadsheet software. • Excellent organizational, customer service, and written and verbal communication skills. • Good judgment skills. • Proficiency in spelling, punctuation, and grammar skills. • Required Software and Tools: Microsoft Office.

🏖️ Benefits

• Subsidized health plans, dental and vision coverage • 401k retirement savings plan with company match • Life Insurance • Paid Time Off (PTO) • On-site cafeterias and fitness centers in major locations • Education Assistance • Service Recognition • National discounts to movies, theaters, zoos, theme parks and more