**Job Title: Redetermination Examiner**
The Redetermination Examiner is responsible for performing reviews of Medicare redeterminations and managing appeals in compliance with CMS regulations. This role focuses on identifying any deficiencies in claims processing, ensuring precise documentation, and making educational referrals to achieve compliant results. Applicants should have a High School Diploma or GED, along with a minimum of 6 months of relevant experience. Excellent analytical abilities, communication skills, and proficiency in PC operations are essential for effectively overseeing the appeals process.
