Appeals Specialist

Broadway Ventures

4h•Remote

About The Position

At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we’re more than a service provider—we’re your trusted partner in innovation. The Redetermination (Appeals) Specialist supports the Medicare Appeals team by performing non-medical reviews, preparing redetermination letters, and ensuring timely and accurate processing. This role requires strong organizational skills, attention to detail, and the ability to work with reports, documentation, and multiple software tools in a fast-paced environment.

Requirements

High School Diploma or equivalent required.
Minimum of 2 years of relevant experience in healthcare, insurance, or Medicare/Medicaid services.
Proficiency with Microsoft Office (Word, Excel, Outlook).
Strong organizational skills with excellent attention to detail.
Effective written and verbal communication skills.
Demonstrated ability to exercise sound judgment and handle confidential information.
Strong spelling, grammar, and punctuation skills.

Nice To Haves

Associate’s or Bachelor’s degree preferred.
Customer service experience preferred.
Medicare-specific experience preferred but not required; comprehensive training provided.

Responsibilities

Perform non-medical reviews and process redetermination letters, ensuring accuracy and compliance with established timelines.
Prepare unit reports, analyze and interpret workload data, and address processing issues using various software tools.
Update letters, templates, and departmental documents as needed.
Gather and prepare documentation for legal inquiries and administrative requests.