Thank you for your interest in working for our Company. Recruiting the right talent is crucial to our goals. On April 1, 2024, 3M Healthcare underwent a corporate spin-off leading to the creation of a new company named Solventum. We are still in the process of updating our Careers Page and applicant documents, which currently have 3M branding. Please bear with us. In the interim, our Privacy Policy here: https://www.solventum.com/en-us/home/legal/website-privacy-statement/applicant-privacy/ continues to apply to any personal information you submit, and the 3M-branded positions listed on our Careers Page are for Solventum positions. As it was with 3M, at Solventum all qualified applicants will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Job Description:
Appeals Spec II (Solventum)
3M Health Care is now Solventum
At Solventum, we enable better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers’ toughest challenges, we pioneer game-changing innovations at the intersection of health, material and data science that change patients' lives for the better while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue.
We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and empathy. Because at Solventum, we never stop solving for you.
The Impact You’ll Make in this Role
As an Appeals Specialist II you will have the opportunity to tap into your curiosity and collaborate with some of the most innovative and diverse people around the world. Here, you will make an impact by:
- Evaluating denied Medicare primary insurance claims in a timely manner
- Appeal denied claims through either Redetermination, Reconsideration, or Administrative Law Judge process, in accordance with State and Federal laws
- Proactively investigating and analyze patient charts by reading documents and computer-based research
- Researching and concisely summarizing the finding in medical records and document where appropriate
- Independently recognizing issues/problems and trends with the ability to communicate with management their findings
Your Skills and Expertise
To set you up for success in this role from day one, Solventum requires (at a minimum) the following qualifications:
- Bachelor’s Degree or higher AND 1 year experience of Medicare appeals process
OR
- High School Diploma/GED from AND 2+ years of Medicare appeals process
Additional qualifications that could help you succeed even further in this role include:
- Proficient communications skills
- Proficient data entry skills
- Demonstrated ability to work effectively and exercise sound business judgement in a team environment, as well as independently
- Ability to communicate proficiently, both verbally and in writing with internal and external customers
- Consistently meet deadlines and maintain production and quality levels as established by management
- Decision making skills
- Organizational Skills
- Excellent accounting skills
- Intermediate phone skills
- Proficient Microsoft office skills
Work location: Remote USA
Travel: No
Relocation Assistance: Not authorized
Must be legally authorized to work in country of employment without sponsorship for employment visa status (e.g., H1B status).
Supporting Your Well-being
Solventum offers many programs to help you live your best life – both physically and financially. To ensure competitive pay and benefits, Solventum regularly benchmarks with other companies that are comparable in size and scope.
Applicable to US Applicants Only:The expected compensation range for this position is $46,377 - $56,684, which includes base pay plus variable incentive pay, if eligible. This range represents a good faith estimate for this position. The specific compensation offered to a candidate may vary based on factors including, but not limited to, the candidate’s relevant knowledge, training, skills, work location, and/or experience. In addition, this position may be eligible for a range of benefits (e.g., Medical, Dental & Vision, Health Savings Accounts, Health Care & Dependent Care Flexible Spending Accounts, Disability Benefits, Life Insurance, Voluntary Benefits, Paid Absences and Retirement Benefits, etc.). Additional information is available at: https://www.solventum.com/en-us/home/our-company/careers/#Total-RewardsResponsibilities of this position include that corporate policies, procedures and security standards are complied with while performing assigned duties.
Solventum is committed to maintaining the highest standards of integrity and professionalism in our recruitment process. Applicants must remain alert to fraudulent job postings and recruitment schemes that falsely claim to represent Solventum and seek to exploit job seekers.
Please note that all email communications from Solventum regarding job opportunities with the company will be from an email with a domain of @solventum.com. Be wary of unsolicited emails or messages regarding Solventum job opportunities from emails with other email domains.
Solventum is an equal opportunity employer. Solventum will not discriminate against any applicant for employment on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or veteran status.
Please note: your application may not be considered if you do not provide your education and work history, either by: 1) uploading a resume, or 2) entering the information into the application fields directly.
Solventum Global Terms of Use and Privacy Statement
Carefully read these Terms of Use before using this website. Your access to and use of this website and application for a job at Solventum are conditioned on your acceptance and compliance with these terms.
Please access the linked document by clicking here, select the country where you are applying for employment, and review. Before submitting your application you will be asked to confirm your agreement with the
terms.
Appeals Specialist II at Solventum summary:
The Appeals Specialist II at Solventum evaluates and appeals denied Medicare claims by conducting thorough investigations and communicating findings effectively. This role requires a blend of analytical skills and proficiency in data management to ensure compliance with healthcare regulations. With a commitment to compassionate healthcare solutions, the specialist plays a pivotal role in enhancing the lives of patients and healthcare professionals.
Keywords:
Medicare Appeals, Claims Processing, Healthcare Administration, Patient Records Analysis, Medical Coding, Data Entry, Regulatory Compliance, Claim Denial, Healthcare Solutions, Appeals Specialist
