We’re seeking a detail-oriented, self-directed individual with:

• Three or more years of experience in a Medicare or Managed Care, specifically benefits, enrollment/disenrollment & grievances and appeals process, required
• Knowledge of Medicare and CMS regulations, required
• Strong knowledge of the health care model and other managed care MSO operations, required
• Strong familiarity with CMS requirements and regulations pertaining to appeals and grievances
• Knowledgeable of physician and facility billing practices, appropriate CPT coding initiatives, ICD-10 coding standards, as well as Revenue and HCPCS coding
  
• Working knowledge of Microsoft Office Suite (i.e., Word and Excel), and Visio and data visualization tools, required
  
• Reliability and compliance with scheduling standards
  
• Strong ability to research and resolve issues