Remote Medicare Provider Education Specialist

Palmetto GBA, LLC; Lexington, Northern (SC, KY); Hybrid; USD 70,000 - 95,000; Full time

Benefits offered by this job

Subsidized health plans

Dental coverage

Vision coverage

401k with company match

Life Insurance

Paid Time Off

Job summary

Palmetto GBA, LLC is seeking a Senior Consultant to educate medical providers on Medicare coverage and documentation. This full-time remote role serves candidates in South Carolina, North Carolina, Georgia and Alabama, with an 8:30 a.m.–5 p.m. schedule.

You will prepare regulatory education materials, conduct workshops, and analyze reports to improve provider performance under the medical review program. Nursing licensure (LPN/LVN/RN) is required, with substantial clinical/educator experience.

Qualifications

• Education must include LPN/LVN or RN licensure.
• LPN or LVN: 7 years clinical or educator experience; RN: 5 years.
• Knowledge of medical terminology and disease processes.
• Proficiency in word processing and spreadsheet software.
• Strong judgment, customer service, organizational and presentation skills.
• Ability to handle confidential information with discretion.
• Active nursing licensure in state hired or compact multistate license.
• Proficiency with Microsoft Office.
• Medicare experience preferred.

Responsibilities

• Educates providers on Medicare coverage, utilization statistics, documentation and medical review via advisories, reports, letters, and calls.
• Documents all provider contacts in the provider tracking system.
• Conducts conference calls or in-person educational visits for high-utilization providers.
• Conducts workshops for provider staff on Medicare coverage and documentation.
• Researches and prepares regulatory-based provider education materials.
• Performs analysis of reports to determine actions on medical reviews and audits.

Skills

Medical terminology

Word processing

Spreadsheet software

Good judgment

Customer service

Organizational skills

Presentation skills

Analytical thinking

Basic math

Discretion with confidential info

Education

LPN (Licensed Practical Nurse)

LVN (Licensed Vocational Nurse)

RN (Registered Nurse)

Tools

Microsoft Office

Microsoft Excel

Microsoft Access

Job description

Palmetto GBA, LLC is seeking a Senior Consultant to educate medical providers on Medicare coverage and documentation. This full-time remote role serves candidates in South Carolina, North Carolina, Georgia and Alabama, with an 8:30 a.m.–5 p.m. schedule.

You will prepare regulatory education materials, conduct workshops, and analyze reports to improve provider performance under the medical review program. Nursing licensure (LPN/LVN/RN) is required, with substantial clinical/educator experience.