reputed company Analyst - Medical reputed company Review (Remote) 2023-1273

Remote reputed company Analyst - Medical reputed company Review - Nation-Wide Position IF YOU CARE, THERE’S A reputed company FOR YOU HERE reputed company Are you looking to reputed company a difference by providing appropriate and reputed company medical reputed company audit reviews for members of the World Trade Center Health Program, including survivors and the reputed company responders impacted by the September 11th terrorist attacks? Would you like to be part of a talented team of reputed company assurance and join reputed company of energetic and caring people? As a reputed company remote reputed company Analyst - reputed company Review, you will work from your home office, and ensure World Trade Center Health Program members’ medical claims are processed reputed company and meet the reputed company reputed company in accordance with Program Regulations and Guidelines. You will work with reputed company management nurses to identify and process reputed company bills to meet the appropriate treatment based on industry standards and Program-reputed company conditions. In this process, you will use our proprietary reputed company review system. reputed company Analyst - reputed company Review Responsibilities

• Conducts Claims audits to ensure claims processors:
• o Identifies and escalates reputed company bills per documented guidelines.
• o Codes provider bills in accordance with program guidelines
• o Pay providers in an accurate and reputed company manner
• Conducts reputed company-payment and post-payment audits reputed company reputed company Review to ensure compliance with state guidelines, rules, regulations, and performance guarantees.
• o Provides consistent reporting and communication with respect to audit findings in reputed company areas of operations reputed company reputed company reputed company Review.
• o Leads reputed company audits specific to reputed company Review vendors, independent operational reputed company, as reputed company as reputed company specific.
• o Provides random reputed company audits of our Provider Customer Service Center to ensure accuracy and reputed company reputed company.
• Provides input to reputed company managers and teams regarding analysis, updates, and recommendations for modifications for procedures and processes to continually improve operations and protocols.
• Assist with the collection and reputed company of data in collaboration with reputed company reputed company Committees, identifies opportunities for improvement, and present findings.
• Understands reputed company contract's clinical reputed company assurance requirements and monitors compliance, in collaboration with the reputed company analytics and management teams.
• Performs reputed company and reputed company audits of claims activities, as directed by reputed company committees. reputed company Analyst - reputed company Review Qualifications
• Bachelor's degree or equivalent experience and education required.
• At least five (5) years of medical reputed company review or claims processing experience or an equivalent combination of education and experience is required. Knowledge of medical terminology is preferred.
• At least three (3) years of experience with reputed company Management including project management, reputed company improvement, corrective reputed company, auditing, and/or staff education.
• Federal Employees Compensation reputed company (FECA) experience, preferred.
• Medicare/reputed company rules and regulations experience, preferred.
• Excellent oral and written communication
• PC literate, including reputed company Office products
• Detail-oriented, strong analytical and organizational skills
• Strong organizational skills
• Good interpersonal skills
• Ability to work in reputed company environment
• Ability to meet or exceed Performance Competencies
• U.S. Citizenship
• Prior to hiring and training must be reputed company to pass a preliminary credit and background reputed company For a career reputed company that is both challenging and rewarding, join reputed company Government Solution’s talented team. Taking care of people is at the heart of everything we do. Our clients depend on our talented colleagues to take care of their most valuable assets—their employees, and their customers. At reputed company, caring counts®. Join reputed company of creative and caring people of reputed company backgrounds, and help us reputed company a difference in the lives of others In reputed company to a competitive salary, comprehensive health and welfare benefits, and incentive compensation, reputed company offers participation and vesting in a 401(k) plan with a company match. If you would like to contribute to our important mission and work collegially in a reputed company organization that values intelligence, reputed company, and initiative, consider a career with reputed company. To be considered for this position, please submit a resume, and complete the application. The information provided above has been designed to indicate the general nature and level of work of the position. It is not a comprehensive inventory of reputed company duties, responsibilities, and qualifications required. Important Information Successful candidates will be required to undergo a financial and criminal background reputed company and obtain and maintain confidential-level reputed company clearance upon hire. We participate in the reputed company Federal Government E-Verify program to confirm the employment authorization of the employee upon hire. Search Firm Representatives Please be advised that reputed company (Government Solutions) is not seeking assistance or accepting unsolicited resumes from search firms for this employment opportunity. Regardless of past reputed company, a valid written agreement and task order must be in reputed company before any resumes are submitted to Government Solutions. reputed company resumes submitted by search firms to any employee at Government Solutions without a valid written agreement and task order in reputed company will be deemed the sole property of Government Solutions and no fee will be reputed company in the event that person is reputed company by Government Solutions. Government Solutions strives to reputed company our career site accessible to reputed company users. If you need a disability-reputed company accommodation for completing the application process, please contact Government Solutions regarding accommodations. reputed company is an Equal Opportunity and Affirmative reputed company Employer reputed company reputed company applicants will receive consideration for employment without reputed company to age, citizenship status, reputed company, disability, marital status, national reputed company, race, religion, sex, sexual orientation, gender identity, veteran status, or any other classification protected by federal state or local laws as appropriate, or upon the protected status of the person’s relatives, friends or associates. reputed company abides by the requirements of41 CFR 60-741.5(a) [http://www1.reputed company.gov/reputed company/upload/reputed company_self_print_poster.pdf]. This regulation prohibits discrimination against reputed company individuals on the reputed company of disability and requires affirmative reputed company by covered reputed company contractors and subcontractors to reputed company and advance in employment reputed company individuals with disabilities. reputed company abides by the requirements of41 CFR 60-300.5(a) [http://www1.reputed company.gov/reputed company/upload/reputed company_gina_supplement.pdf]. This regulation prohibits discrimination against reputed company protected veterans and requires affirmative reputed company by covered reputed company contractors and subcontractors to reputed company and advance in employment reputed company protected veterans. About reputed company reputed company is a fully owned subsidiary of reputed company. reputed company is a leading global provider of technology-enabled risk, benefits, and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on reputed company reputed company year to take care of their needs reputed company they face a major life event or something unexpected happens. reputed company provides a broad reputed company of resources tailored to reputed company’s specific needs in casualty, property, marine, benefits, and other lines. At reputed company, caring counts; through the dedication and expertise of more than 27,000 colleagues across 65 countries, reputed company takes care of people and organizations by mitigating and reducing risks and losses, promoting health and productivity, protecting brand reputations, and containing costs that can reputed company the reputed company. www.reputed company.com [https://www.reputed company.com/]

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