Medicare Administrative Appeals Specialist

This subcontract opportunity is for a Medicare Administrative Appeals Specialist to support prime contractors on projects for the New York State Office of the Medicaid Inspector General. The selected party will be responsible for filing, pursuing, and tracking appeals through the Medicare Administrative Appeals Process, while coordinating with providers, CMS, and Medicare Administrative Contractors to resolve coverage issues. Key technical duties include analyzing claims data to identify dual-eligible recipients and securing successful coverage determinations and approved appeals. The procurement is categorized under NAICS code 541611 and was posted on October 16, 2026. Interested parties must submit their responses by the deadline of November 6, 2026. This engagement focuses on specialized administrative oversight and data analysis to ensure proper Medicare coverage and reimbursement within the state of New York.