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Conditional Payment Specialist

Company: Examworks Group, Inc.
Location: Lawrenceville
Posted on: August 6, 2022

Job Description:

Overview:
Are you someone who enjoys examining information and collecting all of the facts? This position may just be what you are looking for!The Conditional Payment Analyst is responsible evaluating Medicare conditional payment letters and working with clients and Medicare to effectuate a successful dispute or appeal. This position ensures all services are completed with highest quality and integrity and that all work is in full compliance with client contractual agreements, regulatory agency standards and/or federal and state mandates. The Conditional Payment Analyst is also responsible for maintaining communication with the sales team to ensure proper communication with the client.This is a remote full time positionwith a standard work schedule Monday-Friday, 8am-5pm.It may be necessary to work overtime depending on business needs. Read on and apply today. We cant wait to meet you!

Responsibilities:
Evaluate Medicare conditional payment letters, notices and demands to determine the appropriatecourse of action and provide claims-appropriate recommendations to clients.Work with ECS sales team and client / claims handler to obtain all necessary information in order tosuccessfully perform appeal or dispute.Triage conditional payment correspondence upon receipt.Create clear, concise and articulate disputes and / or appeals on behalf of ECS clients.Appropriate documentation of all system notes and e-mails.Working with Team Manager to ensure client correspondence is logical and up to date.Assist with addressing issues and solving problems as needed.Regularly communicates with management and provides support as needed.Perform quality assurance as needed.Perform introductory training to new employees and ongoing training to staff in the conditionalpayment department as needed.Medicare secondary payerDemand letterConditional paymentsStatute of limitationsAppeal(s)Dispute(s)Demand letterCenter for Medicare and MedicaidCommercial Repayment Center

Qualifications:
Minimum 1-3 years of administrative clerical experience.Must have strong knowledge of multiple software programs, including but not limited toMicrosoft Word, Outlook, Excel, and the Internet.Must demonstrate exceptional communication skills by conveying necessary informationaccurately, listening effectively and asking questions where clarification is needed.Must be able to work independently, prioritize work activities and use time efficiently.Must possess the ability to manage change, delays, or unexpected events appropriately.Education and/or ExperienceBachelor's Degree or equivalent required. Experience in the insurance industry preferred.Who We Are:ECS was formed in 2014 from the acquisition and consolidation of two pillars within the Medicare Secondary Payer (MSP) compliance industry: Gould & Lamb, providers of MSP compliance and reporting services, and MedAllocators/Ability Services Network, a national provider of MSP compliance and case management. Launched as Examworks Clinical Solutions, the new company offered unprecedented, integrated services aimed at managing high dollar complex Medicare, medical, and pharmaceutical claims.ECS 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.Equal Opportunity Employer - Minorities/Females/Disabled/Veterans

Keywords: Examworks Group, Inc., Roswell , Conditional Payment Specialist, Other , Lawrenceville, Georgia

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