If you’ve worked healthcare claims and you know how to dig into denials, this role puts you in the “figure it out and fix it” seat. You’ll research appeals and grievances, communicate decisions clearly, and help drive resolutions that protect both the member experience and policy compliance.
About MPF Federal
MPF Federal supports healthcare-related operations with a focus on service, accuracy, and compliance. This role sits in appeals and grievances, helping review and resolve complex issues tied to claim denials and provider complaints. You’ll be part of a team that handles sensitive cases where details and deadlines matter.
Schedule
- Remote, United States
- Independent work style (work is often completed without established procedures)
- Pay varies by county SCA rates
What You’ll Do
- Review, research, investigate, negotiate, and resolve appeals and grievances
- Communicate with internal teams about case issues, implications, and decisions
- Analyze appeals and grievance trends and help identify patterns
- Research and resolve written, complex, or multi-issue provider complaints
- Work independently while serving as a resource to others when needed
- Coordinate others’ activities as assigned
What You Need
- High School Diploma or GED (or higher)
- 2+ years of healthcare claims benefits experience, including researching claim denials
- 1+ year of customer service experience
- 1+ year of claims appeal experience
- Basic proficiency in Microsoft Excel and Word (create, edit, save, send)
- Ability to ask probing questions to uncover root issues
- Analytical thinking and strong problem-solving skills
- Strong time management and organization
- Solid issue resolution skills with internal and external communication confidence
- Knowledge of TRICARE or Medicare (CMS) policies and processes (preferred)
Benefits
- Competitive compensation package
- Medical benefits
- PTO
- Holiday pay
- Additional benefits offered by MPF Federal
Pay is listed at $15.00–$17.75/hour depending on county SCA rates, so if you’re applying, make sure you’re comfortable with that range for your area.
Roles like this usually reward people who are calm, consistent, and annoyingly thorough. If that’s you, you’ll be dangerous here.
Happy Hunting,
~Two Chicks…