Document Reviewer

Ascendo Resources; Mississippi; Remote; USD 75,000 - 90,000; Full time

Job summary

A leading staffing firm is looking for an entry-level Document Reviewer for a medical insurance company. In this role, you will ensure clinic applications for Medicare meet compliance standards through thorough review and assessment of documentation. The position involves direct communication with clinics, maintaining application records, and staying updated on Medicare regulations.

Benefits

Vision Insurance

401(k)

Qualifications

• Entry level position focusing on document review for Medicare compliance.
• Experience with insurance policies and compliance standards is beneficial.
• Strong communication skills needed for interaction with clinics.

Responsibilities

• Evaluate applications for completeness and compliance with Medicare guidelines.
• Identify compliance issues and communicate corrective actions to clinics.
• Maintain organized records of applications and relevant communications.

Skills

Insurance Policies

Compliance Assurance

Quality Control

Communication

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

Associate

• Employment Type

Full-time

• Job Functions
• Administrative
• Customer Service
• Skills
• Insurance Policies
• Compliance Assurance
• Quality Control
• Communication

Ascendo is a certified minority owned staffing firm, and we welcome and celebrate diversity.

Ascendo is an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, parental status, military service or any other characteristic protected by federal, state or local law.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Administrative

• Industries

  Hospitals and Health Care

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Inferred from the description for this job

Medical insurance

Vision insurance

401(k)

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