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Medicare Escalation Specialist Ii Jobs

Medicare Specialist (Remote) Jobs
By Sedgwick At Oregon, United States
Thorough knowledge of claims management
Compiles, reviews and analyzes claim files and/or management reports.
Maintains thorough understanding of service and products offered by Medicare Compliance department.
Excellent oral and written communication, including persuasive writing skills
Strong analytical and interpretive skills
Requests rated-ages; tracks files/requests/submissions through Centers for Medicare and Medicaid Services (CMS) processes; and creates documentation as required.
Medicare Set Aside Specialist
By Sanderson Firm PLLC At Florida, United States
·Strong interpersonal, time management and organizational skills.
·Effective multi-tasking skills in a high-volume environment.
·Excellent written and verbal communication skills.
·Certification as a MSCC, CMSP, CLCP or CNLCP, preferred.
·Understand and apply evidence based medical treatment guidelines, and/or CMS guidelines to future care recommendations.
·Identify and outline Medicare and Non-Medicare covered treatment.
Escalation Specialist Jobs
By Resident At United States
Performs both inbound and outbound support for escalated customers via phone and email to de-escalate and manage challenging situations and circumstances
Works independently to provide best in class customer experience by quickly and thoroughly addressing escalated customers’ concerns
Strong conflict resolution and de-escalation skills
Strong written communication skills and ability to recall and coherently summarize complex issues and situations
Experience handling a high volume of customer escalations
Highly detail oriented and thorough with excellent documentation skills and sense of personal accountability
Medicare Enrollment Specialist Jobs
By VNS Health At , Manhattan, Ny $68,200 - $85,200 a year
Experience marketing to a culturally diverse target population required
Excellent verbal and written communication skills, including the ability to speak in front of large groups required
Coordinates home nursing assessment visits, when appropriate, to ensure successful enrollment into the program.
Educates VNS Health Plans MA and/or MLTC members on MAP and conducts telephonic enrollments into the product.
Performs retention efforts developed by VNS Health leadership to reduce member turnover.
Educates consumers who contact VNS Health Plans via website about VNS Health Plans Medicare products.
Medicare Enrollment Specialist - Remote
By ASK Consulting At ,
Ability to pass licensing exam and Carrier certifications annually and maintain good standing
Actively manage all assigned appointments to ensure all retirees needs are met on a timely basis
Deliver a consistently positive customer experience in a highly ethical and professional manner
Expiry Date: 04 September 2023
Meet and/or exceed monthly sales goals and service levels
Handle inbound service calls by providing accurate and complete information via researching/selling/locating licensed agent
Medicare/Acd Specialist (Rn) - Remote
By Acentra Health At Nashville, TN, United States
Do you value care management and quality improvement?
Knowledge of CMS medical necessity guidelines and benefit coverage criteria strongly preferred.
Are you an experienced Clinical Reviewer looking for a new challenge?
Maintain current knowledge of CMS regulations, guidance documents, and transmittals
Review monthly CPT code report and make suggestions based on the data; review with the Manager prior to meetings
Perform ongoing assessment and maintenance of codes within the ACD and update as appropriate, in collaboration with manager and client
Customer Services Escalation Specialist I
By Los Angeles Times At El Segundo, CA, United States
1+ years of experience in a customer service phasing role (call center, retail, etc.)
Strong written and verbal communication skills
Strong analytical thinking and problem-solving skills
Experience with Social media platforms (FB, Twitter)
Handle Tier 1 customer escalations - (phone, email & chat)
Ensure 24 hr. or less email response rates
Escalation Specialist Iii Jobs
By Stealth Monitoring, Inc. At Dallas, TX, United States
Responsible for understanding client specific requirements.
Additional Duties & Responsibilities for Escalation Specialist III
Previous experience and success as a Detection Specialist preferred.
Knowledge of all verticals and system software within assigned division.
Computer literate and excellent knowledge of video monitoring software.
Decision Quality – Most decisions are correct and accurate using a mixture of analysis, wisdom, judgement, and experience.
Appeals Specialist (Medicare Part B) - Palmetto Gba
By BlueCross BlueShield of South Carolina At Columbia, SC, United States
Experience working with Medicare Part B
Prior medical office or insurance experience strongly preferred.
Our Comprehensive Benefits Package Includes
Performs non-medical reviews and processes redetermination letters ensuring timeliness and accuracy.
Prepares unit reports, analyzes and interprets workload, and processes issues utilizing various software tools.
Updates letters and documents within the department when necessary.
Medicare Specialist (Remote) ($53973.00 - $75562.00 / Year)
By Talentify.io At United States
Thorough knowledge of claims management
Compiles, reviews and analyzes claim files and/or management reports.
Maintains thorough understanding of service and products offered by Medicare Compliance department.
Excellent oral and written communication, including persuasive writing skills
Strong analytical and interpretive skills
Requests rated-ages; tracks files/requests/submissions through Centers for Medicare and Medicaid Services (CMS) processes; and creates documentation as required.
Medicare Specialist (Remote) Jobs
By Sedgwick At Delaware, United States
Thorough knowledge of claims management
Compiles, reviews and analyzes claim files and/or management reports.
Maintains thorough understanding of service and products offered by Medicare Compliance department.
Excellent oral and written communication, including persuasive writing skills
Strong analytical and interpretive skills
Requests rated-ages; tracks files/requests/submissions through Centers for Medicare and Medicaid Services (CMS) processes; and creates documentation as required.
Medicare Specialist (Remote) Jobs
By Sedgwick At Washington DC-Baltimore Area, United States
Thorough knowledge of claims management
Compiles, reviews and analyzes claim files and/or management reports.
Maintains thorough understanding of service and products offered by Medicare Compliance department.
Excellent oral and written communication, including persuasive writing skills
Strong analytical and interpretive skills
Requests rated-ages; tracks files/requests/submissions through Centers for Medicare and Medicaid Services (CMS) processes; and creates documentation as required.
Escalation Desk Specialist Jobs
By Apria Healthcare At , , Az $16.54 - $23.46 an hour
Comprehensive benefits package offered for eligible employees:
At least 2 years related experience is required.
Specific vision abilities required include close vision, color vision, peripheral vision, depth perception and the ability to adjust focus.
We recognize our veterans by offering a company paid day off for Veterans Day
Provides floor support for CS inbound/ CQ team members
Handle supervisor/escalated calls from CS/CQ
Medicare Billing Specialist Jobs
By Home Healthcare, Hospice & Community Services (HCS) At , Remote
Associates degree in accounting or equivalent work experience; Bachelor’s degree preferred
A minimum of two years Medicare billing experience
Working knowledge of accounting principles and Medicare reimbursement system
Review all billing for coding accuracy.
Maintain patient information and make appropriate changes.
Communicate with Medicare, clinical and audit team to promote timely payments.
Medicare Ops Specialist Jobs
By Horizon Blue Cross Blue Shield of New Jersey At , Newark, 07105, Nj $93,000 - $127,050 a year
Requires knowledge of project management methodology.
Requires knowledge of healthcare management.
Requires the ability to apply project management methodologies and practices across multiple projects.
Collaboratively serve as a divisional resource with the Manager for health plan Medicare and Medicaid operations & STAR ratings reporting.
Requires minimum of 6 years professional business experience working preferably in a health care environment.
Requires working knowledge of PC and application software.
Medicare Appeals Specialist Jobs
By BioTAB Healthcare At Maryland Heights, MO, United States
Minimum Qualifications (Knowledge, Skills, And Abilities)
Must have good computer skills, experience with Microsoft Office, required
Use persuasive communication skills to draft appeals and effectively overturn denied or underpaid claims
Researches and monitors issues related to trends that generate cases. Recommends revisions to Revenue Cycle Manager
Experience with Medicare, appeals, denials and processes, minimum 2 years required
Experience in medical device billing and/or general healthcare reimbursement, minimum 2 years required
Medicare Specialist - Remote ($18.91 - $28.03 / Hour)
By Talentify.io At United States
Required Experience, Education And Skills
High School Diploma/GED or equivalent combination or education and experience required.
Basic math and computer skills. The ability to type 30 words per minute is a requirement.
Knowledge of medical terminology and the ability to understand and assess medical documents is strongly preferred.
Experience handling first-party medical claims is preferred.
Negotiating skills and the ability to develop effective negotiating strategies.
Medicare Compliance Specialist, Remote
By AllWays Health Partners At , Somerville, Ma
Knowledge/experience with federal, state and payer-specific regulations
Work is normally performed in a typical remote work environment.
Bachelors Degree or substitution of 5+ years of work experience.
3+ years of experience in the health care industry
Experience in performing highly analytical and critical thinking work
Experience in health care compliance
Business Analyst Ii- Medicare Compliance (Remote)
By UPMC At , Pittsburgh, 15219, Pa $25.52 - $44.13 an hour
Master's degree preferred. Extensive related experience will be considered.
Minimum of two years of related work experience in financial and/or medical analysis required.
Knowledgeable with SharePoint, Access and PowerBi
Experience in health care insurance or health care industry preferred.
Preferred knowledge: SharePoint, Access and PowerBi
Identify trends in expenses, utilization, medical quality, and other areas.
Medicare Enrollment Specialist (Remote) ($28.98 - $46.10 / Hour)
By Talentify.io At United States
2 years direct sales or marketing experience, or any combination of education and experience which would provide an equivalent background
Manage travel and territory efficiently to produce maximum results while generating leads
We welcome 100% remote work for residents who live within a thirty mile radius of Portland, OR.
Required Qualifications For This Position Include
Travel throughout an assigned territory and work directly with community-based organizations, providers, and other sources to obtain referrals
Be responsible for meeting monthly enrollment goals

Are you looking for an exciting opportunity to make a difference in the lives of Medicare beneficiaries? We are looking for a Medicare Escalation Specialist II to join our team and help us ensure that our members receive the highest quality of care. As a Medicare Escalation Specialist II, you will be responsible for resolving escalated issues, providing guidance to members and providers, and ensuring compliance with Medicare regulations. If you have a passion for helping others and a commitment to excellence, then this is the job for you!

Overview:

The Medicare Escalation Specialist II is responsible for providing escalated customer service to Medicare members and providers. This position requires a high level of customer service and problem-solving skills to ensure that all inquiries are addressed in a timely and accurate manner.

Detailed Job Description:

The Medicare Escalation Specialist II is responsible for providing escalated customer service to Medicare members and providers. This position requires a high level of customer service and problem-solving skills to ensure that all inquiries are addressed in a timely and accurate manner. The Medicare Escalation Specialist II will be responsible for researching and resolving complex customer service inquiries, escalating issues to the appropriate department, and providing feedback to the customer. The Medicare Escalation Specialist II will also be responsible for maintaining accurate records of customer interactions and providing feedback to the customer service team.

What is Medicare Escalation Specialist Ii Job Skills Required?

• Excellent customer service and problem-solving skills
• Ability to research and resolve complex customer service inquiries
• Ability to escalate issues to the appropriate department
• Ability to maintain accurate records of customer interactions
• Ability to provide feedback to the customer service team
• Knowledge of Medicare regulations and policies

What is Medicare Escalation Specialist Ii Job Qualifications?

• Bachelor’s degree in a related field
• At least two years of customer service experience
• At least one year of experience in a Medicare-related field
• Knowledge of Medicare regulations and policies
• Excellent communication and interpersonal skills

What is Medicare Escalation Specialist Ii Job Knowledge?

• Knowledge of Medicare regulations and policies
• Knowledge of customer service principles and practices
• Knowledge of problem-solving techniques
• Knowledge of customer service software and systems

What is Medicare Escalation Specialist Ii Job Experience?

• At least two years of customer service experience
• At least one year of experience in a Medicare-related field

What is Medicare Escalation Specialist Ii Job Responsibilities?

• Respond to escalated customer inquiries in a timely and accurate manner
• Research and resolve complex customer service inquiries
• Escalate issues to the appropriate department
• Maintain accurate records of customer interactions
• Provide feedback to the customer service team
• Monitor customer service trends and provide feedback to the customer service team
• Ensure compliance with Medicare regulations and policies