The following are essential tasks of the Rep III (Senior Analyst) position. Daily job duties are not limited to the list below.
• Ability to create projects in Government Reimbursement Manager™
• Utilize MAC portals to complete MBI lookups
• Run projects in Revenue Chance Manager™ and produce results once complete.
• Capability to review return results to ensure project ran successful through HETS and CWF
• Recognize discrepancies between current project and previous projects and alert Lead for further investigation
• Identify accounts in Government Reimbursement Manager™ that need calls and research completed
• Make IVR calls on potential reimbursable claims
• Calls to MAC’s and review in Medicare portals
• Calls to Home Health Agencies and Skilled Nursing Facilities
• Review of external medical records and resources to identify a transfer, and receiving facility information
• Rebill accounts through Medicare portal as well as monitor for claims that have been returned or rejected to guarantee prompt correction and resolution
• Complete payment scrape to identify corrected claims that have paid additional reimbursement.
• Execute existing SQL queries to create monthly logs for Medicare Advantage patients
• Use CMS tools to complete estimated additional reimbursements for eligible claims
• Establish and maintain login credentials for Medicare systems used by colleagues
• Other duties as assigned
What you will bring
• Bachelor's degree
• Intermediate Microsoft Suite skills (Ex: Excel and SQL)
• Robust analytical skills and ability to multi-task with attention to detail and accuracy
• Ability to interact effectively with peers, management and customers
• Proficient in communication, research and critical thinking
• Ability to manage tasks independently, work quickly, take ownership of responsibilities and meet deadlines
• Highly comfortable in a team setting
• Process driven, yet adaptable to change when necessary