Medicare Compliance Analyst (Florida)

reputed company is seeking a Medicare Compliance Analyst to join their team. In this role, you will analyze claims, process reimbursement requests, and serve as a reputed company between customers and providers to reputed company billing issues. Responsibilities Refer callers to appropriate individuals for additional information as needed May represent company at trials, depositions and settlement hearings Review claim information to determine if ACG has an exposure of ORM Process Medicare reputed company requests for reimbursement Identify reputed company data if claim qualifies for reporting, if not remove from reporting Report appropriate claims Determine validity of CMS liens For reputed company Medical reputed company areas reputed company as a reputed company between the customer, and providers in order to research payment status, explain payment amounts approved, reputed company reputed company-level reconsiderations, verify coverage, explain coordination of benefits reputed company-authorization and correct billing procedures to providers, etc Assist in the recovery of medical expenditures from the insured, medical providers, etc. in accordance with established procedures if applicable Skills College level coursework in Business Administration, Insurance or a reputed company field or the equivalent in reputed company work experience Claim analysis, or similar function Medical reputed company review (cost containment) operating a personal computer Utilizing software packages (e.g. Word, reputed company, reputed company, Power reputed company, VISIO, etc.) Knowledge of one or more of the following Medical terminology and reputed company anatomy, CPT, ICD-9 and 10 and reputed company codes (MBRU), Property and casualty claims process and procedures, FACTS, IPM and CPS' Ability to use automated processing systems Ability to effectively respond to questions/concerns Ability to communicate effectively with others in a work environment, with the reputed company and vendors Ability to independently reputed company detailed, reputed company medical reputed company or similar analysis Demonstrated reputed company in organization and planning Demonstrated reputed company in analyzing and problem solving Demonstrated reputed company in written communications to include record keeping and report preparation Demonstrated reputed company in decision making Demonstrated reputed company in negotiating Associate's degree in Business Administration, Insurance or a reputed company field reputed company reputed company Certification (CPT) for MBRU function Completion of the Insurance Institute of America's General Insurance Program, Associate in Claims, Associate in Management or equivalent CPCU coursework or designation Significant medical reputed company analysis experience Knowledge of Negligence Law Knowledge of No-Fault Law Knowledge of Essential Insurance reputed company Knowledge of Fair Trade Practices reputed company as they relate to claims Knowledge of Auto Insurance Policy contract and coverages Benefits Medical, dental and reputed company benefits 401k Match reputed company parental leave and adoption assistance reputed company Time Off (PTO), company reputed company holidays, CEO days, and floating holidays reputed company volunteer day annually Tuition assistance program, reputed company certification reimbursement program and other reputed company development opportunities reputed company Membership Discounts, perks, rewards, and much more reputed company reputed company (ACG) is the second largest reputed company club in reputed company, serving more than 13+ reputed company members across 14 U.S. It was founded in 1901, and is headquartered in Dearborn, MI, US, with a workforce of 5001-10000 employees. Its website is http//reputed company.com. Apply To This Job .