Medical Appeals Specialist (SCA)

Machinify
United States
Workplace: RemoteFull timeUSD 21+ hourlyFunction: Healthcare (Clinical, Medical, Wellness)Experience: 5+ yearsEducation: high_schoolSkills: ["Multitasking","Prioritization","Communication","Detail-oriented","Reliability"]

Process and reconcile provider/MAC medical appeals by accurately receiving, reviewing, forwarding, and uploading appeal documents and requests. Ensure compliance with federal/state regulations, contractual requirements, and company guidelines. Coordinate document distribution to internal teams, maintain daily/weekly production standards, and recommend workflow improvements to boost efficiency, accuracy, and streamlining.

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FursaFursa
Machinify
Machinify
3 days ago

Medical Appeals Specialist (SCA)

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Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI
Last checked: 6 hours agoStatus: Live

Job Summary

Process and reconcile provider/MAC medical appeals by accurately receiving, reviewing, forwarding, and uploading appeal documents and requests. Ensure compliance with federal/state regulations, contractual requirements, and company guidelines. Coordinate document distribution to internal teams, maintain daily/weekly production standards, and recommend workflow improvements to boost efficiency, accuracy, and streamlining.
Location: United States
Workplace: Remote
Employment Type: Full time
Job Function: Healthcare (Clinical, Medical, Wellness)
Seniority: Mid level

Key Responsibilities

  • •Receive, review, and forward appeal documents/requests while ensuring compliance with regulations, contractual requirements, and company guidelines.
  • •Process all appeal documents and requests efficiently and accurately.
  • •Upload media to accounts and confirm successful uploads.
  • •Distribute designated media to other departments as appropriate.
  • •Meet daily/weekly production standards and provide recommendations for workflow and process improvements.

Pay and Benefits

Salary: USD 21 hourly
Perks:Health InsuranceDentalVision401kLearning BudgetFsa/hsaRemote WorkWellness Stipend

Key Requirements

  • •High school diploma or GED required.
  • •5+ years in relevant office/administrative/support roles with progressive complexity, preferably in healthcare.
  • •Knowledge of healthcare audit, appeals processes, claim processing, billing, and recovery (Medicare and Medicaid preferred).
  • •Intermediate MS Excel and MS Word skills.
  • •Strong communication and ability to meet deadlines while maintaining high-quality work.
Experience:5+ yearsHealthcare
Education:High School
Skills:MultitaskingPrioritizationCommunicationDetail-orientedReliability
Languages:English
Tech Stack:MS ExcelMS Word

Company Brief

Machinify
Provides AI-driven predictive maintenance and asset-monitoring solutions for manufacturing and industrial operations, using IoT sensor data and machine learning to reduce downtime, optimize performance, and extend equipment life.
Industry: Industrial Automation
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