Medicare Recovery Specialist

Remote

Full Time

Recovery

Mid Level

JOB DESCRIPTION:

At Sanderson Firm, the Recovery Specialist is responsible for researching, disputing, and finalizing potential financial reimbursement obligations for our clients. This role requires interaction not only with our clients, but with Medicare recovery contractors, Medicare Advantage Plans and their subrogation contractors, Part D Prescription Drug plans and the Department of Treasury. This position requires an ability to understand complex and varying recovery processes, a high level of productivity in a task based/process driven environment, exceptional analytical skills and attention to detail and excellent written and verbal communication skills.

JOB RESPONSIBILIIES:

Perform verifications of Medicare, Medicare Advantage, or Part D Eligibility
Perform verification of Social Security Disability (SSD) entitlement.
Conduct initial research with various Medicare benefit plans to determine if conditional payment or lien obligations exist.
Analyze correspondence received from Medicare benefit plans to determine the accuracy of the recovery action.
Communicate with our client partners to identify accuracy of claim information and investigate opportunities for dispute/lien reduction.
Understand/Apply complex rationales for dispute including medical and legal arguments.
Draft comprehensive disputes and appeals to submit to the appropriate Medicare entity.
Conduct timely and efficient follow ups for all services to maintain appropriate turnaround times
Regularly communicate with management regarding status of verification, disputes/appeals, and all other services to determine other additional support as needed.
Abide by all rules of the company such as safety, confidentiality, and organizational directives.

QUALIFICATIONS:

Associate degree preferred, and 1-3 years of relevant experience in a customer service and/or administrative role.
Ability to demonstrate strong customer service skills.
Ability to work remotely in a productive and efficient manner.
Must have strong knowledge of multiple software programs, including but not limited to Microsoft Word, Outlook, and Excel.
Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively. and asking questions where clarification is needed.
Ability to follow instructions and respond to managements’ directions accurately.
Must possess excellent skills in English usage, grammar, punctuation, and style.
Must be able to work independently, prioritize work activities. and use time efficiently.
Ability to concentrate and multitask in a fast-paced work environment.
Must be able to maintain confidentiality.
Must be able to demonstrate and promote a positive team -oriented environment.
Must be able to work well under pressure and/or stressful conditions.
Must possess the ability to manage change, delays, or unexpected events.
Must demonstrate reliability and ability to abide by the company attendance policy.

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