Remote Medicare Redetermination Examiner

Broadway Ventures LLC; Northern (KY); Hybrid; USD 26,000 - 34,000; Part time

Benefits offered by this job

401(k) match

PTO growth

Life Insurance

Short/Long Disability

Job summary

Broadway Ventures in United States seeks a Redetermination Examiner for a 6-month, 100% remote role. You will conduct Medicare redetermination reviews, respond to appeals, and identify processing deficiencies to ensure CMS compliance.

Training is provided and the position offers a competitive hourly rate. Minimum qualifications include a high school diploma, 6 months experience, and strong prioritization, analytical and communication skills.

Qualifications

• High School Diploma or GED required.
• 6 months’ work-related experience.
• General PC knowledge.
• Strong prioritization, analytical and communication skills.
• Ability to adapt to changes.

Responsibilities

• Conducts redetermination reviews per Medicare rules.
• Responds to incoming appeals with professional, timely, accurate letter writing.
• Researches and identifies claims processing deficiencies and initiates corrective response.
• Evaluates documentation to meet CMS guidelines.
• Submits educational referrals to decrease redeterminations.
• Assists in writing and updating processing guidelines.
• Identifies training needs and assists in training.
• Communicates information to internal and external parties timely.
• Problem solves and researches effectively.
• Processes overpayment appeals as needed.
• Maintains knowledge of CMS/JOA requirements.

Skills

Prioritization

Analytical thinking

Communication

Adaptability

General PC knowledge

Education

High School Diploma or GED

Tools

General PC software literacy

Job description

Broadway Ventures in United States seeks a Redetermination Examiner for a 6-month, 100% remote role. You will conduct Medicare redetermination reviews, respond to appeals, and identify processing deficiencies to ensure CMS compliance.

Training is provided and the position offers a competitive hourly rate. Minimum qualifications include a high school diploma, 6 months experience, and strong prioritization, analytical and communication skills.