Medicare Knowledge Specialist
We currently have opportunities for Medicare Knowledge Specialists. The successful candidates will provide Medicare research, client support, and training to support Burgess’ Medicare reimbursement products. This position reports to the Director of Reimbursement Solutions.
Responsibilities:
• Apply Medicare reimbursement knowledge in supporting Burgess products and services
• Understand capabilities of Burgess Reimbursement System (BRS)
• Research Medicare pricing and payment regulations, reviewing proposed regulation changes and evaluating potential impacts to BurgessGroup clients and products
• Translate complex technical analyses into concise and easily understood business requirements
• Use expert Medicare knowledge to educate the software development team on translating Medicare pricing algorithms by provider type into BurgessGroup’s claims pricing software by preparing business requirements, identifying gaps and troubleshooting
• Monitor changes in claim pricing methods and communicate to appropriate cross-functional areas
• Working through the Client Solutions Manager, provide expert Medicare reimbursement problem-solving support
• Participate in quality checking of BRS as needed
• Developing and conducting Medicare Reimbursement Webinars on specific topic areas
• Participating in BRS client software training
• Conducting Medicare Reimbursement training for clients and internal staff
Requirements
• Bachelor’s degree in Business, Finance, Health Care Management, Information Science or related field/equivalent work experience
• A minimum of seven years’ progressive business experience, preferably in managed care or provider environment
• Significant experience in Medicare Reimbursement methods and policies
• Familiarity with managed care/private payer claims payment systems
• Strong technical and problem-solving skills
• Aptitude for detail-oriented work
• Excellent verbal and written communication skills
• Ability to work independently
• Strong organizational, interpersonal skills and ability to manage multiple projects simultaneously
• Proficiency in the use of Microsoft Office products
Travel 10-15%