The Medicare Compliance team is searching for a Technical Assistant to join its Conditional Payment Unit. In this role, you will work within a lien resolution team analyzing, disputing, and coordinating payment of Medicare & Medicare Advantage plan debt. The candidate will interact with multiple parties including claims case managers, plaintiff attorneys, Medicare vendors, and the recovery contractors for CMS. The right candidate for this role will be comfortable working in a fast-paced environment and committed to producing high-quality work product.
- Analysis of Medicare and Medicare Advantage Plan liens. Specifically, the billing codes associated with the medical care within the lien.
- Creating and filing formal disputes and appeals when an analysis reflects that the debt may not be owed.
- Conducting pre-settlement lien searches and lien updates.
- Data entry associated with conditional payment workflow. Specifically working within Share Point applications.
- Following established procedures and using standard templates, secures authorizations (if applicable) and insures access to online Medicare Secondary Recovery Portal.
- Accesses Medicare Secondary Recovery Portal (online web-portal) to secure updates relative to conditional payments.
- Investigates claims via phone calls to the Medicare Recovery contractors.
- Assists case managers, customers, and policyholders in resolving Conditional Payment-related issues/questions.
- Participates in projects to improve team’s ability to deliver service efficiently and effectively.
- Able to adapt to competing priorities, detail-oriented, execution-focused.
- General knowledge of Microsoft Office Suite applications, specifically Outlook, Word, and Excel.
- Strong written and verbal communication skills via the phone and electronic media.
- Solid organizational skills to manage work inventory within quality and time standards.
- Excellent interpersonal skills to interact with and elicit cooperation from involved parties.
- Associate’s Degree preferred, and one-three years of relevant experience in a customer service and/or administrative role.
- Knowledge of medical terminology, medical billing, ICD9 codes, or Social Security/Medicare policies preferred.