Veteran appeals reviewer skills for your resume and career

Updated January 8, 2025

2 min read

Below we've compiled a list of the most critical veteran appeals reviewer skills. We ranked the top skills for veteran appeals reviewers based on the percentage of resumes they appeared on. For example, 66.6% of veteran appeals reviewer resumes contained appeals as a skill. Continue reading to find out what skills a veteran appeals reviewer needs to be successful in the workplace.

8 veteran appeals reviewer skills for your resume and career

1. Appeals

Here's how veteran appeals reviewers use appeals:

Provided assistance to appeals team as required regarding appeal processing guidelines.
Perform complicated appeals research in which I have to make independent judgment calls based on policy, law, and ethics.

2. CMS

A Content Management System or CMS is computer software that works as a framework where content can be assembled and managed by using a database. CMS is an important asset in web development. This platform enables users to create, edit, collaborate on, publish and store digital content. It helps users to manage their content and modify it from a single system.

Here's how veteran appeals reviewers use cms:

Reviewed and prepared medical records for CMS Major findings discussions for Medical Director.
Researched and applied federal statutes and CMS policies to each case in order to make the correct determination.

3. CPT

CPT is a medical term that stands for Current Procedural Terminology. Whenever a procedure like surgery or diagnosis occurs or some other medical service is rendered to a patient, it is reported to the concerned physician, insurance company, or organization. The aforementioned practice is widely referred to as CPT.

Here's how veteran appeals reviewers use cpt:

Issued pre-authorization, verification of coding and CPT codes for diagnosis and procedures.
Researched and appealed denials with correct coding (ICD-9, CPT, modifiers, etc.)

4. Identify Trends

Identify Trends refers to the act of analyzing recent history and determining how the history connects. This is commonly seen in social media, where trends may be different challenges completed to raise awareness for an organization or disease, or it may be a purchasing trend to determine what product will most likely sell next.

Here's how veteran appeals reviewers use identify trends:

Identify trends and emerging issues and report and recommend solutions.

5. Healthcare

Healthcare is the maintenance or improvement of a person's health by the diagnosis and treatment of a person's injury, illness, or any other disease. Healthcare is a basic necessity of human life and is the responsibility of the country's government to ensure that each person gets healthcare. Providing healthcare is the job of certified health professionals that includes doctors, surgeons, nurses, and other physicians. Pharmaceutical companies, hospitals, dentistry, therapy, and health training all come under healthcare. Healthcare plays a vital role in the country's economy and its development.

Here's how veteran appeals reviewers use healthcare:

Licensed Healthcare Specialist - Receive inbound calls from prospects who are interested in getting a Medicare Health Plan.
Collaborate with physicians, nurses and other healthcare professionals to improve quality, completeness and accuracy of documentation.

6. Appeal Process

Here's how veteran appeals reviewers use appeal process:

Ensured adherence to all company policies concerning appeal processing procedures.
Qualified in resolving issues concerning the appeal process and explain if necessary complex denial reasons clearly and effectively.

7. Medicaid

Here's how veteran appeals reviewers use medicaid:

Conduct post-payment audits for NC Department of Medical Assistance/Program Integrity for behavioral health providers suspected of Medicaid fraud and abuse.
Participated in meetings with inter agencies and other entities as appropriate to facilitate and enhance the Medicaid eligibility determination process.

8. Analyze Data

Analyze data or data analysis refers to the practice of studying, organizing, and transforming data to make it more useful. It also includes the cleansing of non-useful information which helps in better decision making regarding any particular matter. Analyze data is a practice that is used widely in the field of business, social sciences, and science.

Here's how veteran appeals reviewers use analyze data:

Review and analyze data for payment.

What skills help Veteran Appeals Reviewers find jobs?

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List of veteran appeals reviewer skills to add to your resume

The most important skills for a veteran appeals reviewer resume and required skills for a veteran appeals reviewer to have include:

Appeals
CMS
CPT

Identify Trends
Healthcare
Appeal Process

Medicaid
Analyze Data

Updated January 8, 2025

Zippia Team

Editorial Staff

The Zippia Research Team has spent countless hours reviewing resumes, job postings, and government data to determine what goes into getting a job in each phase of life. Professional writers and data scientists comprise the Zippia Research Team.

Updated January 8, 2025

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