Overview:
Are you a medical or legal professional who enjoys examining information and collecting all of the facts? This position may just be what you are looking for!
The Conditional Payment Analyst is responsible evaluating Medicare conditional payment letters and working with clients and Medicare to effectuate a successful dispute or appeal. This position ensures all services are completed with highest quality and integrity and that all work is in full compliance with client contractual agreements, regulatory agency standards and/or federal and state mandates. The Conditional Payment Specialist is also responsible for maintaining communication with the sales team to ensure proper communication with the client.
This is a remote full time position with a standard work schedule Monday-Friday, 8am-5pm. It may be necessary to work overtime depending on business needs.
Read on and apply today. We cant wait to meet you!
Responsibilities:
- Evaluate Medicare conditional payment letters, notices and demands to determine the appropriatecourse of action and provide claims-appropriate recommendations to clients.
- Work with ECS sales team and client / claims handler to obtain all necessary information in order tosuccessfully perform appeal or dispute.
- Respond to internal and external emails and phone calls in a timely manner.
- Triage conditional payment correspondence upon receipt.
- Create clear, concise and articulate disputes and / or appeals on behalf of ECS clients.
- Appropriate documentation of all system notes and e-mails.
- Working with Team Manager to ensure client correspondence is logical and up to date.
- Assist with addressing issues and solving problems as needed.
- Assist other team members as needed and directed by management.
- Regularly communicates with management and provides support as needed.
- Abide by all rules of the company such as safety, confidentiality and organizational directives.
- Perform quality assurance as needed.
- Perform introductory training to new employees and ongoing training to staff in the conditionalpayment department as needed.
- Perform other duties as assigned by management.
Qualifications:
- Minimum 1-3 years of administrative clerical experience.
- Knowledgeable with business terminology, administration and management.
- Experience in the insurance industry preferred.
- Must be able to adequately operate a computer, fax machine, copier, scanner, and telephone.
- Must have strong knowledge of multiple software programs, including but not limited toMicrosoft Word, Outlook, Excel, and the Internet.
- Must be able to add, subtract, multiply, and divide in all units of measure, using whole numbersand decimals. Ability to compute rates and percentages.
- Ability to demonstrate strong customer service skills.
- Must demonstrate exceptional communication skills by conveying necessary informationaccurately, listening effectively and asking questions where clarification is needed.
- Ability to follow instructions and respond to managements directions accurately.
- Must possess excellent skills in English usage, grammar, punctuation and style.
- Must be able to work independently, prioritize work activities and use time efficiently.
- Ability to concentrate and multitask in a fast paced work environment.
- Must be able to maintain confidentiality.
- Must be able to demonstrate and promote a positive team -oriented environment.
- Must be able to work well under pressure and/or stressful conditions.
- Must possess the ability to manage change, delays, or unexpected events appropriately.
- Demonstrates reliability and abides by the company attendance policy.
- Must maintain a professional and clean appearance at all times consistent with companystandards.
- Medicare experience a plus
About Us:
ECS was formed in 2014 from the acquisition and consolidation of two pillars within the Medicare Secondary Payer (MSP) compliance industry: Gould & Lamb, providers of MSP compliance and reporting services, and MedAllocators/Ability Services Network, a national provider of MSP compliance and case management. Launched as Examworks Clinical Solutions, the new company offered unprecedented, integrated services aimed at managing high dollar complex Medicare, medical, and pharmaceutical claims. In May 2020, the organization name was changed to ExamWorks Compliance Solutions. A single word change, but one that truly reflects the core of what is offered by ECS. Today, our mission remains focused on providing the most comprehensive, creative, and customizable compliance andreporting solutions for the marketplace.
ECS is an Equal Opportunity Employer and affords equal opportunity to all qualified applicants for all positions without regard to protected veteran status, qualified individuals with disabilities and all individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age or any other status protected under local, state or federal laws. Equal Opportunity Employer - Minorities/Females/Disabled/Veterans
ExamWorks Compliance Solutions offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.