Conditional Payment Specialist
Lawrenceville, GA 
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Posted 12 days ago
Job Description
Conditional Payment Specialist
Requisition ID 2022-8192
# of Openings 2
Category General and Administration
Location US-GA-Lawrenceville
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 position with 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 can't wait to meet you!

Responsibilities
    Evaluate Medicare conditional payment letters, notices and demands to determine the appropriate
    course 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 to
    successfully 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 conditional
    payment department as needed.

Medicare secondary payer

Demand letter

Conditional payments

Statute of limitations

Appeal(s)

Dispute(s)

Demand letter

Center for Medicare and Medicaid

Commercial Repayment Center

Qualifications
  • Minimum 1-3 years of administrative clerical experience.
  • Must have strong knowledge of multiple software programs, including but not limited to
    Microsoft Word, Outlook, Excel, and the Internet.
  • Must demonstrate exceptional communication skills by conveying necessary information
    accurately, 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 Experience
Bachelor'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. In May 2020, the organization name was changed to ExamWorks Compliance Solutions. A single word change, but one that truly reflects the core of what is offered by ECS. Today, our mission remains focused on providing the most comprehensive, creative, and customizable compliance and
reporting solutions for the marketplace.

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


It is the policy of ExamWorks Group, Inc. and its subsidiaries to employ qualified persons of the greatest ability without discrimination against any employee or applicant for employment because of race, religion, color, sex, physical or mental disability, national origin, age, status as a disabled veteran, a recently separated veteran, an Armed Forces service medal veteran or other protected veteran or any other protected group status and further, to take affirmative action to employ and advance in employment qualified minorities, women, disabled persons, disabled veterans, recently separated veterans, Armed Forces service medal veterans or other protected veterans

 

Job Summary
Company
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
Bachelor's Degree
Required Experience
1 to 3 years
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