Senior Provider Education Consultant – IRF RCD

🕒 Setembro 10

🏈 Alabama, Tennessee – Remoto

🏈 Alabama – Remote 🎸 Tennessee – Remote

⏰ Tempo Integral

🟠 Sênior

💼 Consultor

👻 Score fantasma 42%

O que significa: a chance de ninguém estar realmente contratando para esta vaga.Como ler: 60% ou mais significa que achamos que é uma vaga fantasma. Pontuações mais baixas preocupam menos.Como pontuamos: tempo em aberto, republicações, vagas abertas vs tamanho do time, rapidez para fechar vagas, e se o salário está divulgado.Observação: é uma estimativa de dados públicos, não um julgamento da empresa. Vagas reais podem ter pontuação alta, então use como uma dica, não como um fato.

Candidatar-se

Encontrar Vagas Remotas Similares

BlueCross BlueShield of South Carolina

SiteLinkedInTodas as Vagas

10.000+ funcionários

Fundada em 1946

🏥 Saúde

💼 Consultoria

⚖️ Jurídico

Healthcare • Consulting • Legal

Há mais de seis décadas, a BlueCross BlueShield of South Carolina faz parte do panorama nacional. Nossas raízes estão firmemente enraizadas no estado. Somos a maior companhia de seguros na Carolina do Sul. Somos também a única com uma classificação A+ Superior da A.M. Best. Somos um dos principais administradores de contratos governamentais do país. Operamos um dos centros de processamento de dados mais sofisticados do Sudeste e temos uma diversificada família de empresas subsidiárias.

Descrição

• Provide education to medical providers as warranted • Communicate and educate providers on Medicare coverage, utilization statistics, documentation, and medical review through written advisories, reports, letters, and telephone contacts • Document all provider contacts and communications in the provider tracking system • Conduct formal conference calls and in-person educational visits with providers who overutilize services, are under progressive corrective action, or have unacceptable denial or error rates • Conduct coverage and documentation workshops for Medicare providers and physicians' staff • Research, compose, and coordinate regulatory-based provider education materials • Analyze effective reports to determine actions regarding medical reviews and audits • Determine which providers and services are being overutilized • Work with the medical review department and provide input on actions taken in response to provider billing practices • Target providers where the greatest abuse of the Medicare program has occurred • Participate in the medical review process and inter-reviewer reliability (IRR) studies • Assist in training medical review associates on coverage and medical review processes • Work a scheduled 8-hour shift during normal business hours of 8 a.m. – 5 p.m.

🎯 Requisitos

• Must reside in Alabama, Georgia, or Tennessee • Must be able to travel up to 3-5 days a week, including possible weekday and weekend overnight travel • Position is not eligible for sponsorship now or in the future • If LPN, graduate of accredited School of Licensed Practical Nursing; if LVN, graduate of accredited School of Licensed Vocational Nursing; if RN, graduate of approved School of Nursing • If LPN or LVN, 7 years of clinical experience or equivalent combination of clinical and educator experience • If RN, 5 years of clinical experience or equivalent combination of clinical and educator experience • Knowledge of medical terminology and disease processes • Proficiency in word processing and spreadsheet software • Good judgment skills • Customer service, organizational, and presentation skills • Proficiency in spelling, punctuation, and grammar • Analytical or critical thinking skills • Basic business math proficiency • Knowledge of mathematical or statistical concepts • Ability to persuade, negotiate, or influence others • Ability to handle confidential or sensitive information with discretion • Microsoft Office proficiency • Active LPN or LVN licensure in state hired, or active compact multistate LPN license under the Nurse Licensure Compact (NLC), or active RN licensure in state hired, or active compact multistate RN license under the NLC • Preferred: 3 years of provider relations and Medicare experience • Preferred: IRF (Inpatient Rehabilitation Facility) education consultant experience • Preferred: Knowledge of claims processing software • Preferred: In-depth knowledge of Medicare program, guidelines, and regulations governing coverage • Preferred: Working knowledge of Microsoft Access or other database software

🏖️ Benefícios

• Subsidized health plans, dental and vision coverage • 401k retirement savings plan with company match • Life Insurance • Paid Time Off (PTO) • On-site cafeterias and fitness centers in major locations • Education Assistance • Service Recognition • National discounts to movies, theaters, zoos, theme parks and more • Diverse and inclusive workplace with opportunities to develop skills, advance careers and contribute to company growth • Reasonable accommodations for disabilities, pregnancy-related conditions, and sincerely held religious beliefs

📊 Verifique sua pontuação de currículo para esta vaga

Melhore suas chances de conseguir uma entrevista verificando sua pontuação de currículo antes de se candidatar.

Enviar Currículo