Conditional Payment Specialist (32513)

The Conditional Payment Specialist is responsible for working with Medicare and its contractors to obtain documentation, ensure timely follow ups are made, and timely and accurate updates are provided to clients. This position ensures all services are completed with the highest quality and integrity and all work is in full compliance with client contractual agreements, regulatory agency standards and/or federal and state mandates.

This is a remote full time position with a standard work schedule Monday-Friday, 8am-5pm EST or 9am-6pm EST. It may be necessary to work overtime depending on business needs.

ESSENTIAL JOB FUNCTIONS

• Investigate new referrals, clarify information received with the Conditional Payment Referral Coordinator and the nature of the assignment with the client or Account Executive.
• Follow up with the applicable Medicare contractor to track status of each claim.
• Respond to internal and external emails and phone calls in a timely manner.
• Triage conditional payment correspondence upon receipt.
• Appropriate documentation of all system notes and e-mails.
• Work with Team Manager to ensure client correspondence is logical and up to date.
• Assist with addressing issues and solving problems as needed.
• Assist other team members as needed and directed by management.
• Regularly communicate with management and provide support as needed.
• Abide by all rules of the company such as safety, confidentiality and organizational directives.
• Perform Medicare Eligibility Inquiries and Verifications as needed.
• Perform Medicare Advantage Plan and Medicaid services as needed.
• Perform Treasury-related services as needed.
• Perform other duties as assigned by management.