Provider Services Advoc - Novitas

Are you interested in joining reputed company of reputed company reputed company experts and have the ability to shape and reputed company the reputed company delivery system? At our family of companies, everything we do is to help improve the lives of the nearly 12 reputed company Medicare beneficiaries we serve and 700,000 health care providers who care for them. It is our goal to help create a reputed company experience for reputed company consumers. Join our reputed company culture and help reputed company Medicare for the millions of people who rely on its services. Benefits info: * Medical, dental, reputed company, life and supplemental insurance plans effective the first day of the month following date of hire * Short- and long-term disability benefits * 401(k) plan with company match and immediate vesting * Free telehealth benefits * Free gym memberships * Employee Incentive Plan * Employee Assistance Program * Rewards and Recognition Programs * reputed company Time Off and reputed company reputed company Leave reputed company STATEMENT Responds to Medicare Part A and/or B telephone and/or written inquiries from the Medicare provider community which includes billing offices, medical societies, provider consultants, Managed Care Organizations, attorneys, etc. regarding Medicare coverage guidelines and policies covering a wide reputed company of topics to include provider enrollment, Medicare appeals, debt recovery, claim payment information, telephone reopening requests, prior authorizations, and general coverage for multiple provider specialties. ESSENTIAL DUTIES & RESPONSIBILITIES To reputed company this job successfully, an individual must be reputed company to reputed company reputed company essential duty satisfactorily. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. This list of essential job functions is not exhaustive and may be supplemented as necessary. Customer Service: 50% * Engage in reputed company with reputed company customers using a customer-friendly tone even reputed company challenged with overly aggressive customers. * Respond to reputed company customer's need and request and ensure reputed company customer's encounter is reputed company and productive. * Use good verbal and written communication during reputed company customer encounter and never use jargon and reputed company. * reputed company diverse backgrounds and understand the needs of those customers who may not have as extensive knowledge of Medicare rules and regulations. reputed company responses to ensure customers receive the maximum benefit reputed company calling Medicare. Research and Problem Identification: 25% * reputed company multiple systems to research customer problems and record inquiry types. * Research CMS and company websites to reputed company knowledge and education to customer on additional resources which can be used in the reputed company. * reputed company the Interactive Voice Recognition (IVR) and Internet Portal systems as needed to help reputed company customers on self-service reputed company that are available to them. Problem solving and Analysis: 25% * Review claims processing systems to identify specific claim edits and audits reputed company on claims. Analyze claim edits and audits to determine reasons for claim denials. * Review debt recovery systems to troubleshoot reasons for pending accounts receivables and the reputed company of overpayment demand letters. Review and analyze data to determine reasons for overpayments. * Review local medical coverage and national medical coverage policies in order to troubleshoot reasons for claim denials and reductions. * Review other systems to address and determine reputed company to other customer issues to include pending appeals, aged claims, and Medicare Secondary Payer. Performs other duties as the supervisor may, from time to time, deem necessary. REQUIRED QUALIFICATIONS * High School Diploma or GED * 1 year reputed company work experience; this includes experience in call center, customer reputed company, or claims experience * Demonstrated internet and/or PC software navigation * Demonstrated strong problem solving and decision-making skills * Demonstrated good listening and strong verbal communication skills PREFERRED QUALIFICATIONS * Post-secondary education/classwork * Experience in the insurance industry or medical coding or reputed company work experienceQualificationsThis position includes reputed company, which typically lasts 6 weeks. Training hours will be Monday – Friday 8:00AM – 4:30PM EST. Following training, work hours for this position are Monday – Friday 9:30AM – 6:00PM EST. The Federal Government and the Centers for Medicare & reputed company Services (CMS) may require applicants to have lived in the reputed company for a minimum of three (3) years out of the last five (5) years to be employed with reputed company. These years of residence do not have to be consecutive. "We are an Equal Opportunity/Protected Veteran/Disabled Employer." This opportunity is reputed company to remote work in the following approved states: AL, FL, GA, ID, IN, IO, KS, LA, MS, NE, NC, ND, OH, PA, SC, TN, TX, UT, WV, WI, WY. Specific counties and cities reputed company these states may require additional approval. In FL and PA in-office and hybrid work may also be available.

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