Remote Medicare Provider Education Consultant

Palmetto GBA, LLC; Georgia; Remote; USD 70,000 - 100,000; Full time

Benefits offered by this job

Subsidized health plans

401k retirement savings with company-m

Life Insurance

Paid Time Off (PTO)

Education Assistance

Job summary

BlueCross BlueShield of South Carolina is seeking a Provider Education Specialist to educate medical providers on Medicare coverage, utilization statistics, and documentation. This is a full-time remote position serving South Carolina, North Carolina, Georgia and Alabama with a standard 8-hour shift from 8:30 a.m.

to 5 p.m. Responsibilities include documenting provider communications, conducting workshops, and developing regulatory education materials.

Qualifications

• Knowledge of medical terminology and disease processes.
• Proficiency in word processing and spreadsheet software.
• Strong judgment, customer service, organizational and presentation skills.

Responsibilities

• Communicates/educates providers on Medicare coverage, utilization statistics, documentation and medical review via advisories, reports, letters, and calls.
• Documents all provider contacts/communications in the provider tracking system.
• Conducts conferences/educational visits with providers on over-utilization or high denial rates under medical review.
• Conducts workshops for provider staff on coverage and documentation.
• Researches and coordinates preparation of regulatory-based provider education materials.
• Performs analysis of reports to determine actions for medical reviews and over-utilization.

Skills

Medical terminology

Documentation & records

Presentation skills

Analytical thinking

Confidential info handling

Education

LPN/LVN/RN licensure

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina is seeking a Provider Education Specialist to educate medical providers on Medicare coverage, utilization statistics, and documentation. This is a full-time remote position serving South Carolina, North Carolina, Georgia and Alabama with a standard 8-hour shift from 8:30 a.m.

to 5 p.m. Responsibilities include documenting provider communications, conducting workshops, and developing regulatory education materials.