Provider Enrollment/Case Analyst

Job Description:

C-HIT is seeking a Case Analyst - 2 to receive, process, and render written decisions in support of the Centers for Medicare & Medicaid Services (CMS) Appeals and Rebuttals provider enrollment administrative actions program.

Position Duties:

• Understands and properly uses and interprets various federal policies, regulations, and systems in response to providers that are challenging provider enrollment administrative actions rendered by CMS.
• Manages case workflow through the identification of key issues, analysis of evidence, completion of record documentation, and drafting of decision rationale.
• Acts as internal consultant by providing support to assist Appeals Specialists, other Case Analysts, Project Manager, and QA Manager in the development of written decisions on the Appeal or Rebuttal.
• Follows all detailed instructions when receiving, processing, and rendering written decisions.
• Participates actively in decision-making by offering qualitative feedback, recommendations, and discussing what-if scenarios.
• Influences and analyzes time sensitive case responses.
• Inputs case details in the requisite systems.
• Opportunities for travel may arise occasionally for in-person meetings, trainings, and presentations.

Education and Experience Requirements:

• Possess either: (1) a 4-year degree from an accredited institution (i.e., a Bachelor s degree) with at least year of experience in healthcare regulatory interpretation/application and/or in healthcare compliance, or without Bachelor's Degree with at least 6 year of experience in healthcare regulatory interpretation/application and/or in healthcare compliance.
• Individuals with prior experience in legal writing, arbitration, healthcare regulatory compliance, and/or Medicare billing privileges are encouraged to apply.

Employees of C-HIT shall, as an enduring obligation throughout their term of employment, adhere to all information security requirements as documented in company policies and procedures

C-HIT is an EOE, including disability and veterans.