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Role Description

The Medicare Outreach & Education Specialist plays a crucial role in our Medicare Program by developing and delivering educational content to the provider community regarding current and upcoming CMS regulations. This specialist creates and develops educational materials, hosts events, and analyzes data to improve provider education and reduce billing errors all while working in a fast-paced, remote environment.

• Provides education to Medicare providers, coders, billers, and compliance staff.
• Assists providers in developing best practices to avoid coverage and billing errors.
• Focuses on ensuring a positive customer experience through relationship building with providers, CMS, and other stakeholders.

Qualifications

• Bachelor’s Degree in Communications, Health Education, Nursing OR related field OR equivalent combination of education and experience.
• 3 or more years of experience in a role supporting Medicare.
• 1 or more years specifically in Medicare communications.
• Demonstrated experience developing educational materials and presentations.
• Extensive knowledge of Medicare Part A, Part B and/or Home Health and Hospice program guidelines and PO&E processes.
• Solid knowledge and understanding of medical billing, coding, and insurance processes.
• Proficient with Microsoft Office Suite and using various modes of technology to deliver training (i.e., YouTube Channel, WebEx, etc.).
• Excellent written and verbal communication skills with the ability to present complex information clearly and effectively to diverse audiences.
• Strong interpersonal and relationship-building skills.
• Ability to travel for onsite training and education sessions - Travel will be approximately 15% in the future.

Requirements

• Possess experience working with Medicare.
• Thrive in developing and maintaining positive relationships with healthcare providers, clinics, and medical staff.
• Enjoy planning, developing, coordinating and delivering educational sessions, workshops, and training materials tailored to provider needs.
• Can analyze error data, geographical data, track Medicare regulations, WPS policy guidelines, coverage issues, and keep abreast on upcoming legislation, to determine areas for additional education needs.
• Like to conduct outreach activities that increase provider engagement and awareness of organizational services, programs, and initiatives.
• Have collaborated with clinical and administrative teams to understand provider challenges and develop targeted solutions.
• Would enjoy serving as a resource for providers regarding updates in guidelines, policies, billing procedures and regulatory requirements.
• Can coordinate with internal teams (i.e., Claims, Appeals, Systems, Medicare Internal Processes, Provider Enrollment) to ensure identified issues are communicated and shared with Provider Outreach & Education (POE) staff.
• Can establish and maintain a POE Advisory Group (POE AG) to assist contractors in creation, implementation, and review of provider education strategies and efforts.

Preferred Qualifications

• CMS knowledge of the Home Health and Hospice program.
• Strong facilitation, presentation and training experience to large groups of people.
• MAC contractor experience with FISS, MCS and MAS systems.

Benefits

• Remote and hybrid work options available.
• Performance bonus and/or merit increase opportunities.
• 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately).
• Competitive paid time off.
• Health insurance, dental insurance, and telehealth services start DAY 1.
• Professional and Leadership Development Programs.