Hueman Private Investment Talent Solutions

Lympha Press is hiring a Medicare Appeals Specialist as a full-time job in Chadds Ford, PA.  
 
As a Medicare Appeals Specialist, you will review Medicare denial notices, review patient cases, gather all documentation and submit claims needed for Medicare appeals. You will also assist with all aspects of the Appeals process.
 
Lympha Press is an industry-leading and award-winning organization specializing in home compression therapy products.

Key Responsibilities:  

• Review Medicare Claim Denials.
• Review patient records for accuracy and completeness.
• Review / Audit claims, prepare and submit audit claims for all levels of review up to and including ALJ hearings.
• Maintain Audit sheets in accordance with Company procedures.
• Update company patient database (MSS) on all case activity.
• Deliver feedback to Team Leader on status of Appeals, Denials, and areas of suggested improvement.
• Prepare and submit all aspects of Medicare RAC, TPE, and CERT reviews and audits. 
• Assists with related special projects, as required.
• Works effectively with other company employees, managers, and departments.
• Performs all job functions with Company Mission, Vision, and Goal Statements in mind.

•  High school diploma or GED required; 2-3 years of relevant industry experience or equivalent combination of education and experience preferred. No specific certification or licensure required but preferred.
• Proficiency in basic to intermediate mathematical concepts (fractions, percentages, ratios, and statistical inference) to support job functions.
• Proficient in computers and industry-relevant software, including word processing, spreadsheets, and database management. Ability to learn company-specific software quickly.
• Strong analytical skills with the ability to interpret complex data and produce logical solutions where limited guidance exists.
• Strong interpersonal and communication skills with the ability to read and interpret business and technical information, write reports and procedures, and communicate effectively across the organization.
• Able to work in a standard office setting using standard equipment. Requires sustained attention to detail, stamina to sit for extended periods, and manual dexterity for various office tasks.
• Able to maintain productivity and judgment in a fast-paced environment with occasional schedule adjustments as needed.
• Ability to work independently, manage time effectively, and handle interruptions with professionalism.

For over 40 years, Lympha Press has produced the most well-regarded dynamic compression therapy systems and helped patients all over the world with lymphedema, venous insufficiency, and lipedema manage their condition and improve their quality of life. We are always looking for hard-working, honest people who are motivated to succeed and willing to learn. Lympha Press is honored to be a certified Great Place to Work and recognized as a top employer by Philly Top Workplaces and Fortune Magazine.

If you are interested in learning more about a career with Lympha Press as a Medicare Appeals Specialist apply today!  
AA/EOE/Vets/Disabled