(2010-Present) ExamWorks Clinical SolutionsResearch CoordinatorResponsible for compliance with internal policies and procedures related to client protocols.• Ensure all transactions are handled in a professional and ethical manner according to corporate and departmental policies and industry standards.• Adhere to corporate and departmental policies and procedures.• Obtain pertinent information from outside sources via correspondence and telephone.• Process documents for preparation and submission to Medicare.• Prepare cover letters using computer database.• Perform Data Entry Quality Assurance checks to ensure data is accurate.• Review and reply to incoming emails and voicemails related to Medicare.• Process documents for preparation and submission to Medicare.• Provide status updates on existing claims to customers and third party representatives (2009 – 2010) Emblem Health - Center for Medicare Services Medicare Common Working File Analyst• Investigate and make discretionary decisions to resolve disputes received from Medicare Contractors, Regional Offices, Managed Care Organizations and Congressional offices relating to data applied to the CWF file. Must audit and assure the validity of the records on the CWF File, which includes securing additional information via telephone or by sending a request in writing.• Initiate calls to the Medicare Contractors and Regional Offices to resolve disputes or further develop an MSP situation.• Handle inquiries and calls from CMS Regional Office Staff escalated from the Customer Service Department and through the Electronic Correspondence and Referral System (ECRS).
Listed skills include Insurance, Medicare, Customer Service, Software Documentation, and 36 others.