Medical Financial Representative 169309

Job Title: Medical Financial Representative
Location: Pittsburgh Pennsylvania 15222
Hours: Monday - Friday 8am-4:30pm

Pay: $23.00 - $26.00 per hour
Scheduled Pay: Bi-Weekly
Benefits: Health, Dental, Vision, Life Insurance, and short-term disability after 90 days
Job Type: Full Time

Ready to apply or have questions?

Contact- Ashley Kruger
Call/Text-

Medical Financial Representative Duties and Responsibilities

• Develop and maintain monitoring schedule that ensures all provider entities within the region are monitored at the required frequency.
• Facilitate the discussion and exchange data obtained during monitoring visits with other members of the regional monitoring team, for compilation of reports.
• Develop, schedule, coordinate and conduct training sessions for providers and team members throughout the region.
• Perform on-site monitoring sessions for OLTL enrolled providers with the other regional monitoring team members.
• Interview provider staff, stakeholders, and consumers as part of the monitoring process.
• Assign team members to gather and present the necessary background data to determine what the providers' strengths and weaknesses are at the pre-conference meeting.
• Assist in the preparation of and changes to data collection tools.
• Perform research through direct contact or by electronic means.
• Analyze a variety of material and data and develop conclusions.
• Successfully communicate findings through established reporting formats.
• Assist in the preparation of monitoring objectives.
• Remain alert to indications of fraud, abuse, or deficiencies.
• Participate in conferences and meetings with provider entities.
• Assist in the preparation of training curriculum and materials.
• Participates in the on-site review and evaluation of medical information and examination of medical records and other documentation to assure that eligible recipients receive appropriate and quality medical care through Office of Long-Term Living waivers and programs.
• Interviews consumers, waiver program office staff, and provider staff to evaluate waiver programs performance, according to CMS protocol.
• Compiles, organizes, and evaluates information obtained from waiver program reviews, interviews, and system data collection.

Medical Financial Representative Requirements

• High school diploma or GED - Required
• 1 year experience Medical Assistance and/ or billing processes - Required
• 1 year Customer service or call center experience - Required
• Demonstrate basic computer proficiency, including familiarity with Microsoft Office applications.

Ready to apply or have questions?

Contact- Ashley Kruger
Call/Text-