Redetermination (Appeals) Specialist – Remote

Help support Medicare appeals processing from home while ensuring accuracy, compliance, and timely resolution for beneficiaries.


About Broadway Ventures

Broadway Ventures is an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB) delivering program management, technology, and consulting solutions to federal and private clients. We focus on efficiency, integrity, and innovation, helping organizations improve operations and better serve their communities.
As part of the Appeals team, you’ll support critical Medicare functions that ensure fair, timely, and accurate claim decisions.


Schedule

  • Full-time, 40 hours per week
  • Monday–Friday
  • Remote, work-from-home

What You’ll Do

  • Perform non-medical reviews and process redetermination letters while ensuring accuracy and adherence to deadlines.
  • Prepare unit reports, analyze workload data, and troubleshoot processing issues using multiple software tools.
  • Update letters, templates, and departmental documentation as needed.
  • Gather and organize documentation for legal inquiries and administrative requests.

What You Need

  • High school diploma or equivalent; Associate’s or Bachelor’s preferred.
  • At least 2 years of experience in healthcare, insurance, or Medicare/Medicaid services.
  • Customer service experience preferred.
  • Medicare-specific experience is a plus (full training provided).
  • Proficiency with Microsoft Office (Word, Excel, Outlook).
  • Excellent attention to detail, organization, and communication skills.
  • Ability to exercise sound judgment and handle confidential information.
  • Strong spelling, grammar, and punctuation.

Benefits

  • 401(k) with matching
  • Medical, dental, and vision insurance
  • Life insurance
  • Paid Time Off (PTO)
  • Paid holidays

Open the door to a stable remote career where detail, accuracy, and consistency truly matter.

Happy Hunting,
~Two Chicks…

APPLY HERE