Document Reviewer

Ascendo Resources; Alabama; Remote; USD 65,000 - 80,000; Full time

Job summary

Ascendo Resources is hiring for a key position within a medical insurance company focused on evaluating Medicare applications. The role involves thorough assessments to ensure regulatory compliance, effective communication with clinics, and maintaining accurate records. Ideal candidates will demonstrate attention to detail, regulatory knowledge, and strong communication skills as they facilitate the enrollment process.

Qualifications

• Proficient in evaluating compliance with Medicare guidelines.
• Strong understanding of regulatory standards.
• Excellent communication with clinic representatives.

Responsibilities

• Review and evaluate applications for Medicare compliance.
• Communicate and guide clinics on application requirements.
• Maintain organized records and prepare reports on outcomes.

Skills

Attention to Detail

Regulatory Compliance Knowledge

Communication Skills

Job description

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This opportunity is open to remote work in the following approved states: AL, AK, FL, GA, ID, IN, IO, KS, KY, LA, MS, NE, NC, ND, OH, PA, SC, TN, TX, UT, WV, WI, WY. Specific counties and cities within these states may require further approval. In FL, PA, TX and WI, in-office and hybrid work may also be available

Start Date: July 21st, 2025

We are hiring for a medical insurance company and in this role you will be responsible for the thorough review and evaluation of applications submitted by clinics seeking to enroll in the Medicare program.

The role ensures that all applicants meet the necessary regulatory and compliance standards set by the Centers for Medicare & Medicaid Services (CMS). The reviewer works closely with clinics, ensuring they understand the requirements and helping facilitate a smooth enrollment process.

Key Responsibilities:

Application Review:

• Evaluate submitted applications for completeness, accuracy, and compliance with Medicare guidelines.
• Ensure that clinics meet all eligibility criteria, including proper licensing, credentialing of healthcare providers, and compliance with state and federal regulations.
• Verify the authenticity and accuracy of supporting documentation, including licenses, certifications, and facility credentials.
• Cross-check application information against state and federal databases to confirm compliance with legal and regulatory requirements.

Compliance Assurance:

• Identify any discrepancies, omissions, or non-compliance issues in applications and communicate these to the clinic with recommendations for corrective action.
• Ensure that clinics meet CMS requirements, including quality standards, patient care protocols, and operational practices.

Communication:

• Provide clear and detailed feedback to clinic representatives regarding the status of their application.
• Serve as a point of contact for clinics during the application process, answering questions and providing guidance on Medicare requirements.

Record Keeping:

• Maintain accurate and organized records of all applications, including notes on application status, communications, and final determinations.
• Prepare reports and summaries of application outcomes for internal and external stakeholders.
• Stay updated on changes in Medicare regulations, policies, and procedures to ensure that application reviews are in line with the latest standards.
• Contribute to the development and improvement of application review processes to enhance efficiency and accuracy.

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Full-time

Job function

• Job function

  Administrative and Customer Service

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Inferred from the description for this job

Birmingham, AL $65,000 - $80,000 4 weeks ago

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