Remote Medicare Provider Education Specialist

Palmetto GBA, LLC; Tennessee; A distancia; USD 65.000 - 90.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health plans

401k match

Life Insurance

PTO

Education Assistance

Employee discounts

Descripción de la vacante

Palmetto GBA, LLC is seeking a remote educator to train medical providers on Medicare coverage and documentation. You will travel 3–5 days weekly, conduct workshops, and document all interactions in the provider-tracking system. Must hold active LPN/LVN or RN licensure and have clinical experience.

Responsibilities include evaluating utilization, preparing materials, and guiding corrective actions with medical review. Travel and strict adherence to guidelines are essential.

Formación

• Active licensure in state hired, or compact multistate license (NLC).
• RN licensure in state hired or compact multistate RN license (NLC).
• 7 years clinical experience for LPN/LVN; 5 years for RN.
• Knowledge of medical terminology and disease processes.
• Proficiency in word processing and spreadsheet software.
• Strong customer service, organizational, and presentation skills.
• Ability to handle confidential information with discretion.

Responsabilidades

• Educate providers on Medicare coverage and utilization using advisories, reports, letters, and calls.
• Document all provider contacts in the tracking system.
• Conduct conference calls or in-person visits with providers with high usage or denial rates.
• Lead workshops for provider staff on coverage and documentation.
• Prepare regulatory-based education materials.
• Analyze reports to determine actions on medical reviews.
• Identify over-utilization patterns and advise on corrective actions.
• Collaborate with medical review on billing practices.
• Assist in training medical review associates.

Conocimientos

Medical terminology

Documentation

Analytical thinking

Communication

Confidentiality

Presentation skills

Customer service

Basic math

Negotiation

Educación

LPN/LVN or RN licensure

Herramientas

Microsoft Office

Microsoft Access

Descripción del empleo

Palmetto GBA, LLC is seeking a remote educator to train medical providers on Medicare coverage and documentation. You will travel 3–5 days weekly, conduct workshops, and document all interactions in the provider-tracking system. Must hold active LPN/LVN or RN licensure and have clinical experience.

Responsibilities include evaluating utilization, preparing materials, and guiding corrective actions with medical review. Travel and strict adherence to guidelines are essential.