A leading provider of independent medical exams, peer reviews, bill reviews, Medicare compliance and related services.
Planner
Location
United States
Posted
4 days ago
Salary
$80K - $90K / year
Seniority
Junior
Job Description
Planner
ExamWorks
• The Planner works autonomously to develop Medicare Set-Aside Allocations and other reports as needed within their scope of licensing and/or certifications. • Collects, reviews and analyzes health data from medical records and/or other sources as provided. • Identify future medical needs utilizing medical standards of care and guidelines, in addition to historical trend of care. • Work autonomously and collaborates with all company personnel as needed; including communicating with the accounts and attorneys as needed. • Maintain a quality work product evidenced by acceptable quality scores/score cards. • Participate in company orientation, management meetings and/or conference calls as required to improve self-knowledge and/or for the improvement of the company. • Attend all scheduled conference calls as mandated by management. • Maintain any required credentials and adhere to all codes of ethics required by these credentials. • Ensures all federal Centers for Medicare and Medicaid Services (CMS) requirements and/or state mandates are adhered to at all times. • Provides insight and direction to management on report quality and compliance with all company policies and procedures, client specifications, URAC and CMS guidelines. • Promote effective and efficient utilization of company resources. • Participate in various educational and or training activities as required. • Perform professional duties as assigned by the Manager or upper management.
Job Requirements
- Minimum of an Associates degree or equivalent certification preferred.
- A minimum of one years workers’ compensation and/or case management experience preferred.
- A minimum of one year experience in Medicare Set Asides required.
- Knowledge of the disability and workers' compensation industry including rules and regulations and a full understanding of Medicare rules and regulations.
- Must be able to adequately operate a general computer, fax, copier, scanner, and telephone.
- Must have adequate knowledge of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
- Ability to demonstrate critical thinking and problem solving skills.
- Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed.
- Must be able to work independently, prioritize work activities and use time efficiently.
- Ability to concentrate and multitask in a fast paced work environment.
- Demonstrates accuracy and thoroughness.
- Looks for ways to improve and promote quality and monitors own work to ensure quality is met.
- Must be able to maintain confidentiality.
- Must be able to demonstrate and promote a positive team-oriented environment.
- Must be able to work well under pressure and/or stressful conditions.
- Must possess the ability to manage change, delays, or unexpected events appropriately.
- Must possess excellent skills in English usage, grammar, punctuation and style.
- Demonstrates reliability and abides by the company attendance policy.
Benefits
- Health insurance
- 401(k) matching
- Flexible work hours
- Paid time off
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