Medical Claims Specialist

Job Title

On behalf of CNS Cares, LLC ("CNS" or "Company"), this position is responsible for developing relationships with leads and claimants, associated retiree groups, physicians, authorized representatives, agency personnel, and other various stakeholders associated with the EEOICPA program and other programs as required.

Essential Duties and Responsibilities

Employee must have regular attendance/punctuality, have excellent customer service skills, be able to work with others at all levels of the Company and be completely honest. This position will be in office, without remote capability. Other assigned duties include:

1. Provide assistance to claimants as needed, by guiding claimants through the claim filing process, and supporting in other ways as needed.
2. Determine what benefits these individuals may qualify for under the EEOICPA or other identified programs.
3. Assist in research and gather work history and medical records as necessary.
4. Help claimants file initial claims and refile claims that have been denied.
5. Inform individuals of the resources available that may assist their claim process and overall health and wellness.
6. Answering & returning frequent phone calls/emails in a polite & timely manner with internal and external customers.
7. Maintains industry knowledge by participating in educational and training opportunities.
8. Assists in identifying efficiencies and improving processes.
9. Maintains contact with professionals of various health service agencies, after obtaining a Release of Information, to determine Claimant eligibility services.
10. Occasionally will attend outreach events as needed.
11. Other duties as assigned.

Requirements

Education and/or Experience Required:

• High school Diploma or GED.
• At least two (2) years of related program or clinical/medical experience and/or training.

Related Competencies:

Knowledge of DOL EEOICPA program, knowledge of the EEOICPA application process, specifically the records necessary for any potential claimant to file a claim under the EEOICPA. Knowledge of medical terminology and the ability to translate terminology into verbal and written communication.

Licensure/Certification:

• Valid Driver's License

Clearances:

• Criminal background
• Driving Record
• OIG Exclusion List
• Sex Offender Registry