Planner

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ExamWorks

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 2008

⚕️ Healthcare Insurance

📋 Compliance

💸 Finance

Healthcare Insurance • Compliance • Finance

ExamWorks is a leading provider of independent medical examinations and peer reviews, specializing in services such as bill reviews, Medicare compliance, and document management. With a robust portfolio that includes agile development and enterprise platform solutions, ExamWorks ensures efficient workflow enhancements and compliance auditing across healthcare sectors. The company supports a network of physicians and offers customized services for the management of medical records and claims, prioritizing reliability for clients in various communities.

📋 Description

• The Planner works autonomously to develop Medicare Set-Aside Allocations and other reports as needed within their scope of licensing and/or certifications. • Collects, reviews and analyzes health data from medical records and/or other sources as provided. • Identify future medical needs utilizing medical standards of care and guidelines, in addition to historical trend of care. • Work autonomously and collaborates with all company personnel as needed; including communicating with the accounts and attorneys as needed. • Maintain a quality work product evidenced by acceptable quality scores/score cards. • Participate in company orientation, management meetings and/or conference calls as required to improve self-knowledge and/or for the improvement of the company. • Attend all scheduled conference calls as mandated by management. • Maintain any required credentials and adhere to all codes of ethics required by these credentials. • Ensures all federal Centers for Medicare and Medicaid Services (CMS) requirements and/or state mandates are adhered to at all times. • Provides insight and direction to management on report quality and compliance with all company policies and procedures, client specifications, URAC and CMS guidelines. • Promote effective and efficient utilization of company resources. • Participate in various educational and or training activities as required. • Perform professional duties as assigned by the Manager or upper management.

🎯 Requirements

• Minimum of an Associates degree or equivalent certification preferred. • A minimum of one years workers’ compensation and/or case management experience preferred. • A minimum of one year experience in Medicare Set Asides required. • Knowledge of the disability and workers' compensation industry including rules and regulations and a full understanding of Medicare rules and regulations. • Must be able to adequately operate a general computer, fax, copier, scanner, and telephone. • Must have adequate knowledge of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet. • Ability to demonstrate critical thinking and problem solving skills. • 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. • Ability to concentrate and multitask in a fast paced work environment. • Demonstrates accuracy and thoroughness. • Looks for ways to improve and promote quality and monitors own work to ensure quality is met. • Must be able to maintain confidentiality. • Must be able to demonstrate and promote a positive team-oriented environment. • Must be able to work well under pressure and/or stressful conditions. • Must possess the ability to manage change, delays, or unexpected events appropriately. • Must possess excellent skills in English usage, grammar, punctuation and style. • Demonstrates reliability and abides by the company attendance policy.

🏖️ Benefits

• Health insurance • 401(k) matching • Flexible work hours • Paid time off