Medicare Administrative Contractors (MAC) Feedback Coordinator

Empower AI is AI for government. Empower AI gives federal agency leaders the tools to elevate the potential of their workforce with a direct path for meaningful transformation. Headquartered in Reston, Va., Empower AI leverages three decades of experience solving complex challenges in Health, Defense, and Civilian missions. Our proven Empower AI Platform provides a practical, sustainable path for clients to achieve transformation that is true to who they are, what they do, how they work, with the resources they have. The result is a government workforce that is exponentially more creative and productive. For more information, visit www.Empower.ai.

Empower AI is proud to be recognized as a 2024 Military Friendly Employer by Viqtory, the publisher of G.I. Jobs. This designation reflects the company's commitment to hiring and supporting active-duty and veteran employees.

Empower AI: As the MAC Feedback Coordinator, you will work directly with the Medicare Administrative Contractors (MACs) for questions, concerns or issues related to, or associated with, CERT claims reviews/outcomes. Additionally, you will manage and coordinate special projects for the customer as assigned by the Medical Review Manager and interact with CERT managers to coordinate the flow of information. You will serve as a critical component in meeting our mission of providing excellent services to our customer, stakeholders, and employees. Your experience ensures an exciting and rewarding opportunity to be at the forefront of activities related to implementing healthcare reform on a national level.

Highlights of Responsibilities:

Manages CERT MAC Feedback operations, including the monitoring of Web feedback data entry.
• Responsible for the coordination and completion of projects as assigned including Top 100, Top 200, CERT Accuracy
• Communicates with the customer, stakeholders, and employees.
• Responsible for the coordination and completion of projects as assigned including Subcategories and Documentation matrix.
• Attends weekly calls with customer.
• Interacts with CERT managers to coordinate the flow of information.
• Manages and coordinates special projects as assigned by the Medical Review Manager.
• Monitors Late/Additional Documentation received for re-consideration and assigns it to medical review staff.
• Management of one direct report.
• Completes other projects or duties as assigned by the Medical Review Manager

Requirements:

• Graduate from an accredited Registered Nurse (RN) school (associate degree or diploma based) or Bachelor's Degree (preferred) with active state licensure.
• A minimum of ten (10) years' clinical experience in a medical/surgical setting.
• A minimum of ten (10) years' experience in medical review.
• Current licensure as a Registered Nurse in one or more of the 50 states or D.C.
• Ability to keep sensitive and confidential material private.
• Must have no adverse actions pending or taken against him/her by any State or Federal licensing board or program and must have no conflict of interest (COI).

Preferred Education and Experience:

• Thorough knowledge of the CERT contract requirements.
• Certification as a CCS, CCS-P or CPC preferred.
• Optional - Bilingual (Spanish) - Fluency in reading and understanding Spanish language.

Physical Requirements:

This position requires the ability to perform the below essential functions:

• Sitting for long periods

All hiring and promotion decisions at Empower AI are based on merit to bring the best talent available to contribute to our firm's overall success. It is the policy of Empower AI not to discriminate against any applicant for employment, or employee because of age, color, sex, disability, national origin, race, religion, or veteran status. Empower AI is a VEVRAA Federal Contractor.