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Appeals Specialist
CGS Administrators, LLC. Perform non-medical reviews and process redetermination letters, ensuring timeliness and accuracy .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates proficiency in Microsoft Office, particularly in word processing and spreadsheet software, while ensuring accuracy and timeliness in processing documentation and reports. Strong organizational and communication skills are essential for effective customer service and legal documentation preparation.
Highest-signal resume keywords
Microsoft Office ProficiencyWord Processing SkillsSpreadsheet Software SkillsOrganizational SkillsCustomer Service Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Documentation PreparationData AnalysisReport PreparationIssue ProcessingLegal Inquiry Documentation
Soft Skills
Written Communication SkillsVerbal Communication SkillsGood Judgment Skills
Certifications & Qualifications
CMS Security Clearance
Industry Keywords
Non-Medical ReviewsRedetermination LettersAdministrative RequestsWorkload Analysis
About the role
Key responsibilities & impact- Perform non-medical reviews and process redetermination letters, ensuring timeliness and accuracy
- Prepare unit reports
- Analyze and interpret workload
- Process issues using various software tools
- Update letters and documents within the department when necessary
- Gather and prepare documentation for legal inquiries and administrative requests
Requirements
What you’ll need- High School Diploma or equivalent
- 2 years job related field experience
- Demonstrated proficiency in word processing and spreadsheet software
- Excellent organizational, customer service, written and verbal communication skills
- Good judgment skills
- Proficiency in spelling, punctuation, and grammar
- Proficiency with Microsoft Office
- Must obtain CMS Security Clearance due to Centers for Medicare and Medicaid Services residency requirements
- Position is not eligible for sponsorship now or in the future
Benefits
Comp & perks- 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
- Supplemental pay until enrolled in health benefits 28 days after the hire date