Redetermination Examiner, Medicare Part B – 6 Month Temp

This is a fully remote position, open to applicants in United States.

📋 Description

• Perform redetermination reviews in accordance with Medicare regulations and guidelines.

• Address Medicare appeals in a professional, timely, and accurate manner.

• Draft and edit correspondence to meet current standards.

• Investigate claims processing issues and initiate corrective actions.

• Assess documentation and history against policy criteria and CMS regulations.

• Submit educational referrals to minimize redeterminations.

• Assist in the creation and revision of processing guidelines.

• Identify training and education needs and support training efforts.

• Relay information effectively to both internal and external stakeholders.

• Manage overpayment appeals as necessary.

• Stay informed about systems, processing instructions, CMS, and JOA requirements.

• Research and resolve issues efficiently.

⛳️ Requirements

• High School Diploma or GED.

• Minimum of 6 months of relevant work experience.

• Basic computer knowledge.

• Excellent prioritization, analytical, and communication skills.

• Ability to adapt to changes in the work environment.

• Candidates must reside in and work from an eligible U.S. state upon hiring and throughout their employment.

• Must successfully complete background checks and drug screenings prior to employment; certain positions may require fingerprinting.

🏝️ Benefits

• 401(k) plan with company matching.

• Paid Time Off (PTO) that increases with tenure.

• Comprehensive Health, Vision, and Dental coverage.

• Company-sponsored Life Insurance and optional Voluntary Life Insurance.

• Short-Term and Long-Term Disability insurance.