Overview

Empower AI is AI for government. Empower AI gives federal agency leaders the tools to elevate the potential of their workforce with a direct path for meaningful transformation. Headquartered in Reston, Va., Empower AI leverages three decades of experience solving complex challenges in Health, Defense, and Civilian missions. Our proven Empower AI Platform® provides a practical, sustainable path for clients to achieve transformation that is true to who they are, what they do, how they work, with the resources they have. The result is a government workforce that is exponentially more creative and productive. For more information, visit www.Empower.ai.

Empower AI is proud to be recognized as a 2024 Military Friendly Employer by Viqtory, the publisher of G.I. Jobs. This designation reflects the company’s commitment to hiring and supporting active-duty and veteran employees.

Responsibilities

Empower AI: As the Documentation/ Scheduling Specialist (Claims Analyst II) you will intake, analyze, validate and categorize/classify appeals hearings case documentation from appellants and perform data entry of required field into the CMS Hearings and Appeals tracking system. In addition, you will have responsibility for the coordination and scheduling of hearings with the Hearing Officer, Legal professionals and other interested stakeholders. Finally, overall responsibility includes intake, analysis, and categorization of documentation and scheduling in support of the Medicare Geographic Classification Review Board (MGCRB).

Highlights of Responsibilities:

Issues are found in the case file, such as missing or questionable documentation, the DSS will be responsibility for escalating the matter to the Paralegal staff and/or Hearings officer, as appropriate.
DSS performs an in-depth review to confirm that regulatory requirements are present.
After the appeal is categorized according to the issue and entered into the tracking system, the DSS creates reports, such as Intake Review Report.
The final step in the intake process is the identification of motions, objections, and preliminary matters. Using a checklist, a DSS reviews the appeal to identify any preliminary matters and classify them into matters that can be resolved quickly prior to the commencement of briefing.
After the date and time of the conference is finalized, DSS drafts a Notice of Pre-Hearing Teleconference for the Hearing Officer Review.
After an in-person, video, or telephonic hearing, the DSS makes sure that the HO has received the transcript, uploads it into the tracking system, emails a copy of the transcript to required parties, and contacts the a with information regarding its availability.

Qualifications

Requirements:

Bachelor's Degree or minimum of 4 years of relevant experience
At least 4 years of experience processing documentation and/or managing schedules
Strong organizational, written and oral communication and time management skills
Strong problem solving and critical thinking skills with the ability to quickly adapt to unexpected changes.
Proficient in Microsoft Office (Word, Excel, PowerPoint), and Adobe Acrobat

Preferred Education and Experience:

Experience with Medicare, Legal and/or Medical Terminology
Previous experience with review of Medical Claims and medical record requests.
Experience working with Legal Professionals

Experience in editing and proofreading.

Strong attention to detail, ensuring accuracy and completeness of all documents.

Physical Requirements:

Sitting for long periods

About Empower AI

All hiring and promotion decisions at Empower AI are based on merit to bring the best talent available to contribute to our firm’s overall success. It is the policy of Empower AI not to discriminate against any applicant for employment, or employee because of age, color, sex, disability, national origin, race, religion, or veteran status. Empower AI is a VEVRAA Federal Contractor.

Originally posted on Himalayas

Documentation/Scheduling Specialist at Empower AI Inc.