Team Lead (Part C)

Tmf/C2C • Austin, TX

1d • Remote

About The Position

Provides subject matter expertise to staff and decision makers through technical support and one-on-one training. Serves as a lead staff member and subject matter expert for Appeals Specialists, Clerks, Dispute Resolution Analyst, Intake Specialists, LEP Analysts, and/or Reconsideration Analyst. Uses subject-matter knowledge and judgment related to contract processes to carry out automated tasks or reopening case file requests. Assists with questions related to the contract or project. This may include, but is not limited to, corrections and detailed explanations as to how to properly comply with Centers for Medicare & Medicaid Services (CMS) guidelines. Assists in ensuring the staff or department is meeting goals in support of the contract and company policies. Assists in facilitating meetings, including staff meetings to discuss quality measures and provide training.

Requirements

• High School diploma or equivalent
• Three (3) years general office experience
• College education or technical training in administration, business, or related areas may be substituted for experience on a year per year basis. (Education requirements may be satisfied by full-time education or the prorated part-time equivalent.)

Nice To Haves

• One (1) year Mailroom, Medicare appeals, Managed Care appeals, Healthcare or Health Insurance industry
• Medicare Part C related appeals activities
• Quality Letter System (QLS)
• Medicare Appeal System (MAS)

Responsibilities

• Serves as a lead staff member and subject matter expert for Appeals Specialists, Clerks, Dispute Resolution Analyst, Intake Specialists, LEP Analysts, and/or Reconsideration Analyst.
• Uses subject-matter knowledge and judgment related to contract processes to carry out automated tasks or reopening case file requests.
• Assists with questions related to the contract or project, including corrections and detailed explanations on how to properly comply with Centers for Medicare & Medicaid Services (CMS) guidelines.
• Assists in ensuring the staff or department is meeting goals in support of the contract and company policies.
• Assists in facilitating meetings, including staff meetings to discuss quality measures and provide training.

Benefits

• Medical, dental, vision, life, accidental death and dismemberment, and short and long-term disability insurance
• Section 125 plan
• 401K
• Competitive salary
• License/credentials reimbursement
• Tuition Reimbursement

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED