Remote Medicare Education Specialist

Palmetto GBA, LLC; North Carolina; Remote; USD 60,000 - 90,000; Full time

Benefits offered by this job

Subsidized health plans

401k retirement plan with companymatch

Life Insurance

Paid Time Off (PTO)

Education Assistance

Service Recognition

National discounts

Job summary

Palmetto GBA, LLC, offers a full-time remote education role for providers across SC, NC, GA, and AL. You will educate on Medicare coverage, document all contacts, and lead workshops for staff while coordinating with the medical review team to improve utilization.

The position requires nursing licensure (LPN/LVN/RN) with several years of clinical and educator experience, strong communication, and proficiency in Microsoft Office. Remote work during standard hours is available.

Qualifications

• Knowledge of medical terminology and disease processes.
• Proficiency in word processing and spreadsheet software.
• Good judgment, customer service, and presentation skills.
• Analytical thinking and basic business math proficiency.
• Ability to handle confidential information with discretion.

Responsibilities

• Educates providers on Medicare coverage and utilization using advisories, reports, letters, and calls.
• Documents all provider contacts in the provider tracking system.
• Conducts formal calls and visits for high-usage providers under medical review.
• Leads workshops for provider staff on coverage and documentation.
• Prepares regulatory-based education materials and analyzes reports to guide actions.
• Identifies over-utilization and advises on corrective actions with medical review.
• Collaborates with the medical review team and IRR studies.
• Assists in training medical review associates on coverage and processes.

Skills

Medical terminology

Word processing

Spreadsheet

Customer service

Organizational skills

Presentation skills

Spelling & grammar

Analytical thinking

Business math

Persuasion

Confidentiality

Education

Nurse licensure (LPN/LVN/RN)

Tools

Microsoft Office

Job description

Palmetto GBA, LLC, offers a full-time remote education role for providers across SC, NC, GA, and AL. You will educate on Medicare coverage, document all contacts, and lead workshops for staff while coordinating with the medical review team to improve utilization.

The position requires nursing licensure (LPN/LVN/RN) with several years of clinical and educator experience, strong communication, and proficiency in Microsoft Office. Remote work during standard hours is available.