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NCI: 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 addtion, you will have responsibililty 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 documenation 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 responsiblity 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.

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

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

Physical Requirements:

• Sitting for long periods
• Ambulate throughout an office
• Ambulate between several buildings
• Stoop, kneel, crouch, or crawl as required
• Repeatedly lift and carry weight up to 15 pounds

It is the policy of NCI to provide equal opportunity in recruiting, hiring, training, and promoting individuals in all job categories without regard to race, color, religion, national origin, gender, age, disability, genetic information, veteran status, sexual orientation, gender identity, or any other protected class or category as may be defined by federal, state, or local laws or regulations. In addition, we affirm that all compensation, benefits, company-sponsored training, educational assistance, social, and recreational programs are administered without regard to race, color, religion, national origin, gender, age, disability, genetic information, veteran status, sexual orientation, or gender identity. It is our firm intent to support equal employment opportunity and affirmative action in keeping with applicable federal, state, and local laws and regulations. NCI is a VEVRAA Federal Contractor.