The Role
Reviews and audits Medicare examination files for accuracy, completeness, client compliance, and regulatory adherence. Ensures cases are properly assigned, quotes examination fees, supports billing data entry, requests physician invoices, and assists customer service, scanning, and mail functions. Maintains confidentiality and escalates case issues while following HIPAA and applicable state and federal requirements.
Summary Generated by Built In
ExamWorks Compliance Solutions is seeking a detail-oriented individual to join the team as a Medicare File Coordinator.
The Medicare File Coordinator is responsible to ensure information is entered correctly and to the highest quality and integrity and is in full compliance with client contractual agreement, regulatory agency standards and/or federal and state mandates. This position is required to assist customer service team and provide overall support to the Customer Service Department
This is a *remote* full time position with a standard work schedule Monday-Friday, 8am-5pm (must be able to work Eastern time zone).
RESPONSIBILITIES:
- Performs quality assurance reviews of information, correspondences and files
- Ensures all cases contain the correct information for the examination process
- Audits files to ensure that all client instructions and specifications have been followed
- Completes and ensures all examination fees are quoted daily and are in accordance with company practices
- Ensures that the appropriate board specialty has received the case in compliance with client specifications and/or state mandates and is documented accurately
- Assists with data entry of billing information
- When necessary, notifies management of any case issue or concerns requiring management’s attention
- Ensures all practices are carried out in accordance with HIPAA compliance practices, state and federal safety standards and legal regulations
- Calls for invoices from physicians
- Assists with mail as needed
- Assists with the scanning of documents
QUALIFICATIONS:
- High school diploma or equivalent required
- A minimum of two years clinical or related field experience; or equivalent combination of education and experience required
- Medicare knowledge or experience a PLUS
- Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet
- Must possess excellent skills in English usage, grammar, punctuation and style
- Demonstrates accuracy and thoroughness. Looks for ways to improve and promote quality and monitors own work to ensure quality is met
- Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed
- Must be able to maintain confidentiality
- Must be able to demonstrate and promote a positive team -oriented environment
Who We Are:
ECS was formed in 2014 from the acquisition and consolidation of two pillars within the Medicare Secondary Payer (MSP) compliance industry: Gould & Lamb, providers of MSP compliance and reporting services, and MedAllocators/Ability Services Network, a national provider of MSP compliance and case management. Launched as Examworks Clinical Solutions, the new company offered unprecedented, integrated services aimed at managing high dollar complex Medicare, medical, and pharmaceutical claims. In May 2020, the organization name was changed to ExamWorks Compliance Solutions. A single word change, but one that truly reflects the core of what is offered by ECS. Today, our mission remains focused on providing the most comprehensive, creative, and customizable compliance and
reporting solutions for the marketplace.
reporting solutions for the marketplace.
ECS is an Equal Opportunity Employer and affords equal opportunity to all qualified applicants for all positions without regard to protected veteran status, qualified individuals with disabilities and all individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age or any other status protected under local, state or federal laws.
Equal Opportunity Employer - Minorities/Females/Disabled/Veterans
Equal Opportunity Employer - Minorities/Females/Disabled/Veterans
ExamWorks Compliance Solutions offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.
Skills Required
- High school diploma or equivalent
- At least two years of clinical or related field experience, or an equivalent combination of education and experience
- Knowledge or experience with Medicare
- Knowledge of Microsoft Word, Outlook, Excel, and the Internet
- Excellent English usage, grammar, punctuation, and style skills
- Accuracy, thoroughness, and commitment to quality
- Exceptional communication skills, including accurate information sharing, listening, and clarification
- Ability to maintain confidentiality
- Ability to promote a positive, team-oriented environment
- Ability to work remotely Monday through Friday, 8 a.m. to 5 p.m. Eastern Time
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The Company
What We Do
ExamWorks Compliance Solutions is a leading authority on Medicare compliance and mandatory insurer reporting. The company provides comprehensive, customizable reporting and compliance solutions, including Medicare Set-Asides (MSAs), conditional payment services, and outcome management. Leveraging clinical and legal expertise, it serves property and casualty insurance carriers, law firms, and government agencies to manage complex medical and pharmaceutical claims.
