TA Claims Preparation

Are you interested in joining a team of experienced healthcare experts and have the ability to shape and transform the healthcare delivery system? At our family of companies, everything we do is to help improve the lives of the nearly 12 million Medicare beneficiaries we serve and 700,000 health care providers who care for them. It is our goal to help create a better health experience for all consumers. Join our winning culture and help transform Medicare for the millions of people who rely on its services.

SUMMARY STATEMENT
This position is responsible for providing technical guidance to the section's employees responsible for opening, sorting, and distributing all incoming Medicare mail, the sorting, activating, and distribution of all written Medicare inquiries, the sorting of all claims and development response letters, the processing of all mail returned from the post office as undeliverable, and the operation of imaging, OCR Scanning and verifying functions, triaging images to the correct classification, and image QC functions. The incumbent will assist the supervisor in resolving procedural and operational problems and write protocols and guideline changes.

This incumbent is expected to meet quality and production standards established by Management.

ESSENTIAL DUTIES & RESPONSIBILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This list of essential job functions is not exhaustive and may be supplemented as necessary.

Provides technical, operational and procedural guidance to section employees specifically as it pertains to the opening, sorting, and distributing of all Medicare mail. This includes resolving processing problems and issues, assuring section personnel access to current reference materials and assuring consistency and accuracy in processing procedures. The incumbent provides data reports related to mail and incoming claims, and advises the Supervisor of system and procedural problems. (60%)

Provides technical and procedural coaching for improved employee performance. This involves evaluating individual and sectional production and quality data. The incumbent provides for continuous employee development and/or performance improvement. This includes assisting with performance analysis, monitoring and communicating goal setting, and routine monitoring, mentoring, employee training, reviewing problem areas with employees and orientation and training of new employees. The incumbent also provides input for performance appraisals, maintains quality records, and advises the Supervisor of section personnel having production, quality or other work related problems. (30%)

Shares responsibility for quality with every other member of Novitas. As part of this responsibility, the incumbent is accountable for identifying quality-related problems and notifying management when they believe quality is being compromised. Furthermore, the incumbent is expected to recommend process improvements designed to improve accuracy, timeliness of processing, and/or eliminate manual effort required. (10%)

Performs other duties as the supervisor may, from time to time, deem necessary.

The Federal Government and the Centers for Medicare & Medicaid Services (CMS) may require applicants to have lived in the United States for a minimum of three (3) years out of the last five (5) years to be employed with the Company. These years of residence do not have to be consecutive.

"We are an Equal Opportunity Employer/Protected Veteran/Disabled"