Conditional Payment Specialist
2 weeks ago
About the Role:
We are seeking a highly skilled Conditional Payment Analyst to join our team at ExamWorks Compliance Solutions. As a Conditional Payment Analyst, you will play a critical role in evaluating Medicare conditional payment letters and working with clients and Medicare to effectuate a successful dispute or appeal.
Responsibilities:
- Evaluate Medicare conditional payment letters, notices, and demands to determine the appropriate course of action and provide claims-appropriate recommendations to clients.
- Work with the ECS sales team and client/claims handler to obtain all necessary information to successfully perform an 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.
- Document all system notes and emails.
- Work with the 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 communicate with management and provide support as needed.
- Abide by all company rules, including safety, confidentiality, and organizational directives.
- Perform quality assurance as needed.
- Perform introductory training to new employees and ongoing training to staff in the conditional payment 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.
- Ability to operate a computer, fax machine, copier, scanner, and telephone.
- Strong knowledge of multiple software programs, including Microsoft Word, Outlook, Excel, and the Internet.
- Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers and decimals.
- Ability to demonstrate strong customer service skills.
- Excellent communication skills, including conveying necessary information accurately, listening effectively, and asking questions where clarification is needed.
- Ability to follow instructions and respond to management's directions accurately.
- Excellent skills in English usage, grammar, punctuation, and style.
- Ability to work independently, prioritize work activities, and use time efficiently.
- Ability to concentrate and multitask in a fast-paced work environment.
- Ability to maintain confidentiality.
- Ability to demonstrate and promote a positive team-oriented environment.
- Ability to work well under pressure and/or stressful conditions.
- Ability to manage change, delays, or unexpected events appropriately.
- Demonstrates reliability and abides by the company attendance policy.
- Maintains a professional and clean appearance at all times consistent with company standards.
- Medicare experience a plus.
About Us:
ExamWorks Compliance Solutions 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.
Benefits:
ExamWorks Compliance Solutions offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.
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