Job Description

Position Summary

Join Infocrossing INC as a Medicare BPO Specialist, where you'll play a crucial role in managing and processing Medicare claims with precision and attention to detail. This role demands a strong understanding of Medicare rules, claims data entry, and problem-solving capabilities to ensure claims are handled efficiently and accurately.

As part of the BPS-IHS delivery unit, you will be working within a dynamic team focused on excellence in healthcare business process services. Your contributions will directly impact the accuracy of Medicare claims submissions and the satisfaction of our clients.

Key Responsibilities

• Accurately enter Medicare claims data including patient, insurance, and billing information into designated systems.
• Analyze and reconcile rejected claims daily, determining root causes and applying appropriate solutions.
• Manually correct claims data when necessary to ensure compliance with Medicare requirements.
• Stay current with CMS Medicare federal regulations to ensure policy compliance and correct application in claims processing.
• Identify opportunities to innovate and enhance workflow efficiencies, leading initiatives that streamline processes.
• Effectively communicate complex Medicare program rules and claim issues with clients and internal stakeholders.
• Conduct thorough investigations into escalated claims issues to provide timely resolutions.
• Participate in miscellaneous projects that contribute to team and organizational objectives.
• Perform additional duties to support the department’s goals as needed.

Experience and Education

• Minimum of a High School Diploma or equivalent credential required.
• Preferred candidates will have 3 or more years of Medicare claims data entry experience within healthcare settings.
• Background in healthcare operations or claims processing is advantageous.

Skills and Knowledge

• Strong proficiency in Medicare Fee for Service claims processing policies and procedures, with a solid grasp of Medicare Advantage and Part D programs.
• Experience working with Plexis system and Payer Compass preferred.
• Exceptional attention to detail with the ability to thrive in a fast-paced work environment.
• Strong analytical and problem-solving abilities to manage complex claim data and queries.
• Effective time management and communication skills to handle multiple tasks and collaborate with various teams.
• Capability to interpret and apply complex regulations accurately and efficiently.
• Ability to remain composed and maintain productivity when handling stressful or challenging situations.

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Core Competencies

• Client Centricity: Commitment to understanding and delivering on client needs, ensuring high levels of satisfaction and service quality.
• Passion for Results: Strong drive to achieve accuracy, efficiency, and timely completion of Medicare claim processing tasks.
• Execution Excellence: Consistent ability to follow through with processes meticulously, with a focus on precision and compliance.
• Collaborative Working: Work effectively with team members, management, and other departments to achieve shared goals and resolve issues swiftly.
• Learning Agility: Openness to adapt and acquire new knowledge, especially regarding evolving Medicare policies and procedural updates.
• Problem Solving & Decision Making: Analytical mindset to assess complex claims data, identify issues, and determine best courses of action.
• Effective Communication: Clear and concise communication skills, capable of explaining intricate guidelines and claim statuses to both internal and external audiences.

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Company Overview

Infocrossing INC is dedicated to delivering exceptional Business Process Services through a robust partnership with our clients. Embedded in the BPS-IHS sector, we pride ourselves on integrating technology and expertise to contribute toward the digital transformation of healthcare administrative processes.

Our culture champions innovation, inclusivity, and continuous learning, empowering our associates to achieve career growth and personal development. We value diversity and foster an environment where every individual’s contribution propels our collective success.

Join us to be part of a mission-driven team that is transforming how healthcare claims are managed and processed, ensuring compliance and client satisfaction every step of the way.

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Compensation and Benefits

The expected compensation range for this role is competitive and will be commensurate with the selected candidate’s experience, skills, and geographic location. In addition to salary, Infocrossing INC offers a comprehensive benefits package, including:

• Medical, dental, and vision insurance plans to support your health and wellbeing.
• Disability insurance to provide security during unforeseen circumstances.
• Generous paid time off policies including sick leave and personal days.
• Opportunities for professional development and continuous learning programs.
• Supportive work environment that promotes work-life balance.

Please be advised that employment may be contingent upon successful completion of a post-offer drug screening in accordance with applicable laws.

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Equal Employment Opportunity and Inclusion

Infocrossing INC is proud to be an equal opportunity employer. We are committed to fostering a diverse and inclusive workplace that celebrates individual differences and offers equal opportunities for all applicants and employees without discrimination based on race, color, religion, age, sex, national origin, disability status, veteran status, sexual orientation, gender identity or expression, or any other protected characteristic under applicable federal, state, or local laws.

We strongly encourage veterans, individuals with disabilities, and candidates from all backgrounds to apply. Our inclusive culture supports a collaborative environment where all voices are heard and valued.

Embark on a career with us where innovation, purpose, and reinvention are core values, and where you have the opportunity to shape your professional journey within a forward-thinking organization.