Qureos Mentor

Med-Metrix

Job Purpose
 The Licensed Appeal Writer supports the Company by reviewing insurance claims denied for payment on behalf of our client hospitals. Working closely with nurses and other team members, the Licensed Appeal Writer creates appeal letters in support
 
Duties & Responsibilities
 
<ul>
<li>Review denied insurance claims</li>
<li>Review patients’ medical files</li>
<li>Develop strategies to reverse claim denials</li>
<li>Create written appeals</li>
<li>Manage and organize appeal workflow based on internal, client-based, and insurance-driven deadlines</li>
<li>Other duties as assigned</li>
<li>Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards</li>
<li>Understand and comply with Information Security and HIPAA policies and procedures at all times</li>
<li>Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties</li>
</ul>
Qualifications
 
<ul>
<li>4-year degree or work equivalency required</li>
<li>Must hold an active license as a Physician's Assistant (PA), Registered Nurse (RN), Nurse Practitioner (NP), Licensed Practical Nurse (LPN), Physical Therapist (PT), Occupational Therapist (OT), or an equivalent professional license</li>
<li>Must be able to prioritize workload based on strict deadlines</li>
<li>Must be tech-savvy with ability to quickly learn new software</li>
<li>Must possess a high level of reading comprehension and ability to analyze medical information and terminology</li>
<li>Proficiency in Microsoft Office Suite</li>
<li>Strong interpersonal skills, ability to communicate well at all levels of the organization</li>
<li>Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses</li>
<li>High level of integrity and dependability with a strong sense of urgency and results oriented</li>
<li>Excellent written and verbal communication skills required</li>
<li>Gracious and welcoming personality for customer service interaction</li>
</ul>
Working Conditions
 <ul>
<li>Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.</li>
<li>Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.</li>
<li>Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.</li>
<li>Work Environment: The noise level in the work environment is usually minimal.</li>
</ul>
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

Licensed Appeal Writer - Remote

Job Purpose
 The IT Consultant provides expert advice and practical solutions to help Med-Metrix leverage technology effectively. This role focuses on assessing client needs, designing efficient IT strategies, and implementing systems that improve business performance, security, and scalability.
 
Duties & Responsibilities
 
<ul>
<li>Analyze IT environments to identify opportunities for improvement and optimization, including identifying and addressing particular/specialized problems and working towards resolution</li>
<li>Develop and/or implement technology strategies that align with business objectives</li>
<li>Advise on software, hardware, and network solutions to enhance operational efficiency</li>
<li>Support the integration, configuration, and deployment of IT systems and applications</li>
<li>Ensure system security, data integrity, and compliance with industry standards</li>
<li>Collaborate with clients and internal teams to define project goals, timelines, and deliverables</li>
<li>Stay updated on emerging technologies and recommend innovations where appropriate</li>
<li>Other duties as assigned</li>
<li>Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards</li>
<li>Understand and comply with Information Security and HIPAA policies and procedures at all times</li>
<li>Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties</li>
</ul>
Qualifications
 
<ul>
<li>Bachelor’s degree in Information Technology, Computer Science, or a related discipline</li>
<li>Proven experience in IT consulting, systems administration, or a similar technical role</li>
<li>Strong understanding of IT infrastructure, cloud computing, networking, and cybersecurity</li>
<li>Ability to manage multiple projects and work with diverse teams</li>
<li>Proficiency in Microsoft Office Suite</li>
<li>Strong interpersonal skills, ability to communicate well at all levels of the organization</li>
<li>Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses</li>
<li>High level of integrity and dependability with a strong sense of urgency and results oriented</li>
<li>Excellent written and verbal communication skills required</li>
</ul>
Working Conditions
 
<ul>
<li>Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.</li>
<li>Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.</li>
<li>Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.</li>
<li>Work Environment: The noise level in the work environment is usually minimal.</li>
</ul>
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

IT Consultant

Join Med-Metrix and explore 2   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Med-Metrix

About Company

Licensed Appeal Writer - Remote

IT Consultant