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Provider Services Advocate - Customer Service

Mechanicsburg, PA
TDY will consider a candidate’s compliance with the application instructions to be indicative of the type of conduct that it may expect from the candidate during employment. Therefore, failure to comply with these instructions may be grounds for exclusion from employment consideration.

Please read everything below before applying and only apply if you are fully qualified.  Must have computer experience.  Please submit a resume with 3 professional references - please list your skills online in the area provided after you hit the APPLY button.  If you do not submit a resume with professional references, you will not be considered for employment.  You will be required to take a typing test with 90% accuracy at no less than 30 WPM.  You must also pass a reading comprehension test and achieve an advanced level score.  If you cannot type at least 30 words per minute you are not qualified for this position.

TDY does extensive background checks, reference checks and pre-hire/random drug screening as a condition of employment.    You must have computer experience beyond using the internet and email!
 
  • This is a 37.5 hour weekly position
  • Training hours will be 830a-430p
  • After successful completion of training, work hours will be flexible between 630a-600p


The Provider Services Advocate responds to Medicare Part A and/or B telephone and/or written inquiries from the Medicare provider community which includes billing offices, medical societies, provider consultants, Managed Care Organizations, attorneys, etc. regarding Medicare coverage guidelines and policies covering a wide range of topics to include provider enrollment, Medicare appeals, debt recovery, claim payment information, telephone reopening requests, and general coverage for multiple provider specialties.
 
ESSENTIAL DUTIES & RESPONSIBILTITIES
Research and Problem Identification:
o Access multiple systems to research customer problems and record inquiry types.
o Research CMS and company websites to provide knowledge and education to customer on additional resources which can be used in the future.
o Access the IVR and Internet Portal systems as needed to help educate customers on self-service options that are available to them.

Problem solving and Analysis:
o Review claims processing systems to identify specific claim edits and audits applied on claims. Analyze claim edits and audits to determine reasons for claim denials.
o Review debt recovery systems to troubleshoot reasons for pending accounts receivables and the generation of overpayment demand letters. Review and analyze data to determine reasons for overpayments.
o Review local medical coverage and national medical coverage policies in order to troubleshoot reasons for claim denials and reductions.
o Review other systems to address and determine resolution to other customer issues to include pending appeals, aged claims, and Medicare Secondary Payer.

Customer Service:
o Engage in dialogue with all customers using a customer-friendly tone even when challenged with overly aggressive customers.
o Respond to each customer’s need and request and ensure each customer’s encounter is positive and productive.
o Use good verbal and written communication during each customer encounter and never use jargon and slang.
o Embrace diverse backgrounds and understand the needs of those customers who may not have as extensive knowledge of Medicare rules and regulations. Tailor responses to ensure customers receive the maximum benefit when calling Medicare.
 
Performs other duties as the supervisor may, from time to time, deem necessary.
 
REQUIRED QUALIFICATIONS:
  • High School Diploma or GED;
  • 1 year related work experience;
  • This includes experience in call center, customer focus, or claims experience;
  • Proficient with Microsoft Office to include Outlook;
  • Demonstrated Internet research skills;
  • Strong problem solving and decision making skills; and
  • Good listening and strong verbal communication skills.
 
PREFERRED QUALIFICATIONS:
  • Some college education
  • Experience in the insurance industry or medical coding or related work experience
  • Bilingual skills
We do extensive background checks and pre-employment drug screening.
 
TDY Medical Staffing, Inc. is an Equal Opportunity Employer and takes pride in maintaining a diverse environment.  All qualified applicants will receive consideration for employment without regard to their race, color, religion, gender, gender identity, national origin, age, sexual orientation, marital or protected veteran status, disability, or any other legally protected status.  If you’d like more information about your EEO rights as an applicant under the law, please click here.

Once you hit the “Apply Now” button, you will be directed to enter into your information into our website general application – There will be several questions asked to ensure our Affirmative Action/EEOC compliance. 
 

TDY is a federal contractor and as such is required to provide self-identification questions regarding  race/gender/disability/veteran status to all qualified applicants.  We offer all applicants the VOLUNTARY opportunity to respond to the questions. 
You are under no obligation to respond to the questions and not answering the questions will have no impact on the application process or hiring decisions.  Your responses are not seen by the hiring authority and have zero impact on our decision making process.  Submitting this general application is not an offer of employment and does not a guarantee that the application process will proceed. 
 

 
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