Rhode Island Licensed Medicare Coordinator

Job Summary

Supporting the Revenue Cycle Medicare Part B Team, the full-time Medicare Part B Operations Coordinator will manage claims processing activities, ensure compliance with CMS requirements, and facilitate prescriber documentation collection while working remotely.

Key responsibilities

• Facilitate accurate claim processing and submission for Medicare Part B, including manual interventions
• Maintain a centralized repository of prescriber documentation and leverage data to identify actionable claim volume
• Assist in initiatives to reduce bad debt and mitigate legal risk in accordance with federal and state requirements

Required qualifications

• 1+ years of experience in retail pharmacy, PBM, or account management
• 1+ years of professional experience with MS Excel and Access
• Verifiable High School Diploma or GED required; Associate's Degree preferred
• Strong organizational and diagnostic skills with a focus on accuracy and follow-through
• Ability to communicate clearly and professionally with internal and external stakeholders