Provider Outreach and Education Representative

Position is Eligible for Remote / Work from Home Opportunity

Department:
Provider Education

Telecommuting Eligible:
Yes

Job Grade: N14

As a condition of employment, physical work location must be in one of the 50 states or the District of Columbia.

Notice of Collection & Privacy Policy for Applicants Residing in California:
California Applicant Privacy Policy | Noridian ()

Provider Outreach and Education Representative I

The Provider Outreach and Education (POE) Representative is responsible for providing education to providers/suppliers that focuses on reducing the Comprehensive Error Rate Testing (CERT) and reducing claim submission errors based on data analysis. This position produces educational material and web content on topics including enrollment, billing, coding, and new initiatives and delivers education through various innovative technologies.

• Provides one-on-one provider/supplier education
• Collects and analyzes data to track and trend for purposes of education and reduction of workloads in respective operational teams affected
• Excellent interpersonal and communication skills with the ability to lead in a group setting

• Educates, coordinates, and facilitates provider/supplier education opportunities via teleconference, online venues, leading in-person work groups, or group settings as the Subject Matter Expert (SME)
• Provides quality education in a timely manner to meet internal and external standards as outlined by the Centers for Medicare & Medicaid Services (CMS)
• Analyzes data and tracks trends in claim submission errors, appeals, telephone and written inquiries, or other data from operational teams, and educates as appropriate
• Maintains extensive knowledge of CMS rules, regulations, processing guidelines, and online reference information
• Communicates and coordinates with internal departments and senior leadership for educational opportunities that will help improve the workloads (volume, content, promotion of updates/changes, etc.) for each operational team, as applicable
• Researches, problem solves, and responds to complex inquiries from internal and external customers within specified time frames
• Participates in, and actively supports, internal/external committee meetings such as Medicare Carrier Advisory Committee (CAC), coverage meetings, and Ask the Contractor Teleconferences (ACTs), etc.
• Creates and updates written publications, 508 accessibility compliant content for web pages, presentations, and proposals for national speaking opportunities
• Coaches and mentors peers/employees on the education process, Medicare policies, standards, requirements, metrics, etc.
• Actively contributes or takes the initiative to plan the upcoming years' education events, such as onsite travel, webinars, and the contractor, etc.
• Ensure CMS reporting requirements are met with detailed information
• Creates and updates internal control documentation to stay in compliance with International Organization of Standards (ISO) metrics
• Understands and applies confidentiality and security guidelines
• Identifies process improvement opportunities and takes initiatives to streamline and communicate to management team
• Serves as an expert witness at trials

• Creates and interprets data analysis and runs reports as needed
• Other duties as assigned

• Associates degree or 4 years' Medicare experience
• Strong written and verbal communication skills
• Professional writing skills
• Demonstrated problem solving skills
• Ability to plan, organize and prioritize
• Ability to work under time constraints

• 4 years' Medicare experience
• Prior training and/or public speaking experience
• Previous call center experience
• Knowledge of the Medicare claims processing program
• Knowledge of CMS regulations and guidance

• Office Environment
• Ability to read, hear, speak, keyboard, reason, communicate effectively and problem solve
• Requires prolonged sitting and telephone use
• Requires the use of office equipment such as computer terminals, telephones, copiers and printers
• Infrequent lifting to 40 pounds
• Require sitting, standing, walking, stooping, kneeling, carrying, reaching, pushing, and pulling
• Travel up to 30%

Every employee is responsible to perform their duties and responsibilities in accordance with Noridian values, policies and procedures, including but not limited to:
Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian Compliance Program and any other applicable laws, rules and regulations.

This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of all tasks and functions. Employees may be requested to perform job related tasks other than those specifically listed in this description and may be required to…