Globe Life is hiring experienced Medicare Examiner 2024 | Apply now

Medicare Examiner at Globe Life Company

Company Overview:

Globe Life is a major issuer of existence coverage and related financial offerings, dedicated to handing over top-notch fees and guides to our policyholders. With a prolonged-status reputation for integrity and innovation, we provide some merchandise designed to satisfy the numerous wishes of our customers. Our group is dedicated to excellence, and we are seeking out proficient individuals to join us in our venture to provide great issuer and make an incredible impact on the lives of our clients.

Position Summary:

Globe Life is searching for a detail-orientated and experienced Medicare Examiner to enroll in our institution. In this position, you’ll be answerable for reviewing and analyzing Medicare claims to ensure compliance with regulatory necessities and enterprise organization regulations. The Medicare Examiner will play a vital position in retaining the accuracy and integrity of our claims processing operations, identifying and resolving issues, and contributing to the overall performance of our claims control machine.

Key Responsibilities:

• Review and analyze Medicare claims submitted via policyholders, healthcare businesses, and different stakeholders to ensure accuracy, completeness, and compliance with Medicare regulations and corporation tips.
• Verify eligibility and coverage facts for Medicare claims, making sure that each vital documentation and supporting information is furnished and accurate.
• Conduct thorough investigations and audits of Medicare claims to become aware of discrepancies, capability fraud, and billing errors. Take suitable corrective movements and talk findings to relevant parties.
• Collaborate with inner businesses, collectively with claims processors, customer service representatives, and prison advisors, to treat complicated issues and offer steering on Medicare-related topics.
• Monitor adjustments in Medicare regulations, guidelines, and techniques, and replace internal techniques and schooling materials consequently to ensure persevered compliance.
• Provide great customer service with the aid of addressing inquiries and issues from policyholders, healthcare carriers, and distinct stakeholders regarding Medicare claims and insurance.
• Prepare and preserve targeted information and evaluations associated with Medicare claims, audits, and investigations. Ensure documentation is whole, correct, and in compliance with regulatory necessities.
• Assist in the development and implementation of best practices and approach enhancements to enhance the performance and effectiveness of Medicare claims processing operations.

Qualifications:

• Bachelor’s degree in Healthcare Administration, Business Administration, or an associated field. Relevant certifications or greater schooling in Medicare compliance and claims processing are a plus.
• Proven experience in Medicare claims processing, medical billing, or healthcare administration, with robust expertise in Medicare regulations and recommendations.
• Excellent analytical capabilities with the ability to study and interpret complicated claims information, grow to be aware of discrepancies, and make knowledgeable alternatives.
• Strong hobby to detail and accuracy, with the capability to govern multiple responsibilities and priorities in quick-paced surroundings.
• Effective conversation abilities, both written and verbal, with the potential to interact professionally with policyholders, healthcare businesses, and internal teams.
• Proficiency in the usage of claims management software programs, digital fitness statistics (EHR) structures, and Microsoft Office programs (e.g., Excel, Word, Outlook).
• Ability to keep confidentiality and manage touchy information with discretion and integrity.

Preferred Qualifications:

Experience with Medicare Advantage and Medicare Part D claims processing.
Familiarity with ICD-10 coding, CPT codes, and specific scientific coding systems.
Knowledge of healthcare compliance and regulatory requirements beyond Medicare.

Why Join Us?

At Globe Life, we fee our employees and try and create supportive and profitable artwork surroundings. We offer competitive salaries, complete advantages applications, and possibilities for expert increase and development. As a Medicare Examiner, you will play a key position in ensuring the accuracy and integrity of our claims processing operations, contributing to the overall success of our employer.

If you are a dedicated and professional professional with an ardor for Medicare compliance and claims manipulation, we encourage you to use and become a part of the Globe Life crew. Your information and dedication will help us to deliver extraordinary providers and guides to our policyholders.