Remote Medicare Provider Education Specialist

Blue Cross Blue Shiel

Georgia

On-site

USD 70,000 - 100,000

Full time

14 days+

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Benefits offered by this job

Education Assistance

401k retirement savings plan with公司

Job summary

BlueCross BlueShield of South Carolina is seeking a remote Education Specialist to train medical providers on Medicare coverage and documentation. You will travel up to 3–5 days a week, educating staff and reviewing provider utilization to ensure compliance.

Qualified candidates hold LPN/LVN/RN licensure with relevant clinical experience and strong communication skills. The role offers comprehensive benefits and a remote work option, with travel as required.

Qualifications

Knowledge of medical terminology and disease processes.
Proficiency in word processing and spreadsheet software.
Good judgment, customer service, organizational and presentation skills.
Analytical or critical thinking and basic business math.
Ability to handle confidential information with discretion.
Strong spelling, punctuation and grammar.
Ability to persuade, negotiate, or influence others.

Responsibilities

Educates providers on Medicare coverage and related data via advisories and calls.
Documents provider contacts in the provider tracking system.
Conducts conference calls and in-person education visits for high-usage providers.
Plans and conducts workshops for provider staff on coverage and documentation.
Prepares regulatory-based education materials.
Analyzes reports to guide actions on medical reviews and audits.
Identifies over-utilization patterns and advises actions.
Supports training of medical review staff and IRR studies.
Participates in provider relations and medical review activities.