Senior Provider Education Consultant - IRF RCD

Summary Provides education to medical providers as warranted. Description Logistics: Palmetto GBA– one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This is a full-time remote position . You must reside in Alabama, Georgia, or Tennessee. You will work an 8-hour shift scheduled during our normal business hours of 8 a.m. – 5 p.m. Must be able to travel up to 3-5 days a week. There may be some weekday and weekend overnight traveling involved. May include travel outside of the assigned areas of Alabama, Georgia, or Tennessee as necessary. Sponsorship : This position is not eligible for sponsorship now or in the future. What You’ll Do: Communicates/educates providers on issues such as Medicare coverage, utilization statistics, documentation and medical review by use of written advisories, reports, letters, and telephone contacts. Documents all provider contacts/communications in provider tracking system. Conducts formal conference calls and/or in-person educational visits with providers that are consistently over utilizing services, on progressive corrective action, or have unacceptable denial rates and/or error rates under the medical review program. Conduct…