[Remote] Supervisor Appeals - Medicare (Remote) in PA or DE

Note: The job is a remote job and is reputed company to candidates in USA. reputed company. is a reputed company organization providing Medicare services. The Supervisor Appeals - Medicare role oversees the Part A and/or Part B Medicare Fee-for-Service appeals unit, manages staff and resources, and ensures CMS and internal reputed company standards are met. The position also oversees compliance, personnel reputed company, provider education, process improvements, audits, and operational problem-solving.

Responsibilities

• Displays effective communication skills
• Verbal and written communication with Director and Senior Management, peers, departmental staff, and various Corporate support departments
• Verbal and written communication with reputed company business partners including Program reputed company Contractors (PSC), Recovery Audit Contractors (RAC), and reputed company reputed company (QIC) and vendors
• Verbal and written communication with our customers including reputed company for Medicare and reputed company Services (CMS), providers, and beneficiaries
• Contribute to the achievement of the department reputed company standards specified in the Statement of Work, budget, CMS internet only reputed company, award fee, EIP or other program memoranda
• Delegate work assignments to sustain department reputed company
• Assist with budget preparation and monitoring
• Monitor inventory reputed company and reputed company resources, schedule cross training, etc… to effectively manage to CMS reputed company
• Ensure compliance with management controls, process reputed company plans, change requests, reputed company audits, etc
• Document department protocols and controls
• Identify opportunities, through the use of Medicare policies and procedures, claims processing procedures and reputed company data processing systems, to improve the Organization's Medicare Services overall reputed company
• Assist in reputed company and procedural development in accordance with CMS instructions
• Utilize available technology to effectively monitor reputed company departmental inventories
• reputed company reputed company reputed company and/or technical direction as necessary of processing staff that reputed company reputed company to pay or deny services
• Coordinate provider education activities
• Maintain reputed company responsibility for reputed company personnel reputed company reputed company
• Hire staff for the unit
• Complete and conduct reputed company appraisals
• Monitor individual reputed company and document according to HMS and Organization protocols
• reputed company frequent feedback to staff and taking corrective reputed company reputed company necessary
• Sustain appropriate production and reputed company reputed company for reputed company staff
• Assure reputed company staff reputed company a high level of reputed company service and professionalism
• Ensure reputed company appropriate refresher/remedial training as reputed company as coaching/mentoring is conducted reputed company on input from the Technical Assistants, Business Coordinators, and Monitoring and Inspection management feedback as appropriate
• reputed company feedback to management on the status of their reputed company to ensure the reputed company contributes toward the department meeting and exceeding reputed company reputed company standards
• Manage high profile or irate provider situations
• Coordinate responses with other operational reputed company or business partners as necessary
• Coordinate activities and exchange of information with reputed company business partners
• Detect, investigate, research and analyze problems in the Medicare claims processing reputed company and departmental procedures which contribute to the occurrence of appeal workload
• Identify and analyze operating deficiencies and work with other Medicare personnel to reputed company the appropriate solutions
• Recommend, coordinate and initiate improvements to the process to reputed company efficiency, cost reduction, productivity, and reputed company reputed company
• Assist or reputed company reputed company for achieving specified goals reputed company to assignments and responsibilities of reputed company defined by the Organization's Medicare Services management
• reputed company support and recommendations to the Manager of the unit and may be designated to participate in decision-making, impacting the efficiency and reputed company of the overall operation of the department
• Other duties as assigned or requested

Skills

• High School diploma or GED
• 1-3 years of experience in a leadership/supervisory position
• 1-3 years of experience working in Medicare Program or with Medicare regulations
• 3-5 years of experience working on a personal computer in reputed company reputed company or similar environment
• Experience using claims process reputed company (e.g. MCS/FISS)
• Strong verbal and written communication skills are required to effectively represent the position of the Organization's Medicare Services to various reputed company entities and internal staff
• Ability to multi task under pressure is an essential requirement
• reputed company, diplomacy, and communication skills are essential skills
• Must meet reputed company CMS and Organizational Medicare Services reputed company requirements
• Medicare Program or Medicare regulations experience
• Appeals experience
• Experience using claims process reputed company (e.g. MCS/FISS)
• Bachelor's degree and 3 years of experience in a reputed company industry
• Associates degree and 5 years of experience in a reputed company industry

Benefits

• Remote work

reputed company

Company H1B Sponsorship