Administrative Appeal Specialist

1 day ago


Cambridge, Massachusetts, United States Ternium Full time

Job Summary:

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We are seeking a skilled Staff/Associate Attorney to join our team at Ternium. As a key member of our staff, you will be responsible for representing healthcare providers in denied claim disputes and developing innovative arguments to resolve these cases.

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Key Responsibilities:

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  • Conduct research and analysis to support business model development.">
  • Leverage payor provider manuals and managed care contracts to resolve denied medical claims.">
  • Work directly with provider representatives and enhanced resolution units to resolve complex issues.">
  • Provide education and training to recovery staff team members.">
  • Represent healthcare providers in denied claim disputes through an administrative appeals process.">
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Requirements:

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  • Juris Doctor required.">
  • State Bar Membership (preferred).">
  • Strong analytical and problem-solving skills.">
  • Excellent written and verbal communication skills.">
  • Ability to work independently and as part of a team.">
  • Attention to detail and prioritization within a dynamic environment.">
  • Able to adhere to all HIPAA and company policies and regulations.">
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What We Offer:

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  • Starting salary $55,000-$65,000 per year (commensurate with experience).">
  • Competitive benefits package, including 401(k) with corporate match, dental insurance, employee assistance program, flexible schedule, health insurance, vision insurance, life insurance, paid time off, bar due reimbursement, and bonus opportunities.">
  • Opportunity to grow personally and professionally with a dedicated and supportive team experiencing tremendous growth.">


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