Post job

Explore jobs

Find specific jobs

Explore careers

Explore professions

Best companies

Explore companies

OverviewJobs

Skills

EducationDemographicsJob DescriptionHow To HireBest CompaniesJob OutlookCompare
zippia ai icon

Automatically apply for jobs with Zippia

Upload your resume to get started.

Medicare correspondence representative skills for your resume and career

Updated January 8, 2025
4 min read
Below we've compiled a list of the most critical medicare correspondence representative skills. We ranked the top skills for medicare correspondence representatives based on the percentage of resumes they appeared on. For example, 17.8% of medicare correspondence representative resumes contained patients as a skill. Continue reading to find out what skills a medicare correspondence representative needs to be successful in the workplace.

15 medicare correspondence representative skills for your resume and career

1. Patients

Here's how medicare correspondence representatives use patients:
  • Filed secondary insurance for medicare/Medicaid patients
  • Visited with more than 75 patients and/or family members on a weekly basis who were admitted as Medicare Patients for services.

2. Appeals

Here's how medicare correspondence representatives use appeals:
  • Responded timely to Medicare appeals from providers and beneficiaries.
  • Receive, review and respond to requests from customers on a post-claim basis in the first step of the appeals process.

3. Customer Issues

Here's how medicare correspondence representatives use customer issues:
  • Consulted with leadership on challenging customer issues to identify optimal solutions.
  • Worked as a mediator between DHL and Express One Corporate Office in resolving billing and other customer issues.

4. CMS

A Content Management System or CMS is computer software that works as a framework where content can be assembled and managed by using a database. CMS is an important asset in web development. This platform enables users to create, edit, collaborate on, publish and store digital content. It helps users to manage their content and modify it from a single system.

Here's how medicare correspondence representatives use cms:
  • Provide information and education on Medicare insurance plans; qualify Eligibility through telephonic enrollments using CMS guidelines.
  • Handled inbound calls in effort to coordinate Medicare beneficiary's other health insurance applicable to CMS Medicare Secondary Payer guidelines.

5. Medicaid

Here's how medicare correspondence representatives use medicaid:
  • Utilize EMOMED to verify patient eligibility and claim account information regarding Medicaid coverage.
  • Worked with state Medicaid to ensure timely receipt of provider numbers and proper notification of provider numbers for Third Party processing.

6. Inbound Calls

Here's how medicare correspondence representatives use inbound calls:
  • Provided general Medicare information on inbound calls from beneficiaries.
  • Responded to all inbound calls from doctors' offices and Medicare Beneficiaries pertaining to coverage questions and claims processing.

Choose from 10+ customizable medicare correspondence representative resume templates

Build a professional medicare correspondence representative resume in minutes. Our AI resume writing assistant will guide you through every step of the process, and you can choose from 10+ resume templates to create your medicare correspondence representative resume.

7. Outbound Calls

An outbound call is made by the call center representative to the customers on behalf of the company. Such calls help increase sales and generate revenue for the organization.

Here's how medicare correspondence representatives use outbound calls:
  • Place outbound calls to providers under the direction of medical management to obtain clinical information for review of medical authorizations.
  • Managed incoming/outbound calls from members and providers working closely with locations with plan information, claims filling and eligibility issues.

8. Medicare Part D

Here's how medicare correspondence representatives use medicare part d:
  • Maintain end-to-end compliance with all state, federal and other regulatory Medicare Part D requirements.
  • Educate customers on Medicare Part D prescription drug plans RX plan designs.

9. Health Insurance

Here's how medicare correspondence representatives use health insurance:
  • Communicate and document inquiries from members and providers to clarify health insurance coverage and medical claims for accurate tracking and analysis.
  • Collaborated with community based organizations and agencies to provide help for those looking to apply for government subsidized health insurance.

10. Insurance Carriers

Here's how medicare correspondence representatives use insurance carriers:
  • Check web based site for completed physician's statement forms for different insurance carriers
  • Worked with different insurance carriers writing the Medicare Part C plans.

11. Hippa

HIPAA, which stands for Health Insurance Portability and Accountability Act, is a United States federal statue created, enacted, and turned to law in 1996, which whose primary purposes were to modernise the healthcare systems in the United States, secure and generally enhance the management of that personal information of patients that was in the hands of healthcare facilities, such as hospitals and insurance companies, and to enable the providing of healthcare and insurance to more people.

Here's how medicare correspondence representatives use hippa:
  • Provided professional and confidentiality with patient information due to HIPPA regulations.
  • Be sure HIPPA laws are fallowed daily and on every call.

12. Durable Medical Equipment

Here's how medicare correspondence representatives use durable medical equipment:
  • Verify Medicare Eligibility and coverage for durable medical equipment.
  • Submitted durable medical equipment claims.

13. Medical Necessity

Here's how medicare correspondence representatives use medical necessity:
  • Researched Medicare cases submitted by providers and beneficiaries to determine if medical necessity criteria was met.
  • Fax Certificates of Medical Necessity.

14. Medical Claims

Here's how medicare correspondence representatives use medical claims:
  • Analyzed data and documentation of medical claims and made independent judgments whether payment of claims should be allowed or denied.
  • Processed, researched and investigated Medicare Part B medical claims.

15. HIPAA

Here's how medicare correspondence representatives use hipaa:
  • Followed specific HIPAA guidelines as set forth by company regulations.
  • Communicate effectively with insurance providers, patients and medical personnel, while answering phones and maintaining conformity with all HIPAA regulations.
top-skills

What skills help Medicare Correspondence Representatives find jobs?

Tell us what job you are looking for, we’ll show you what skills employers want.

List of medicare correspondence representative skills to add to your resume

The most important skills for a medicare correspondence representative resume and required skills for a medicare correspondence representative to have include:

  • Patients
  • Appeals
  • Customer Issues
  • CMS
  • Medicaid
  • Inbound Calls
  • Outbound Calls
  • Medicare Part D
  • Health Insurance
  • Insurance Carriers
  • Hippa
  • Durable Medical Equipment
  • Medical Necessity
  • Medical Claims
  • HIPAA
  • CPT
  • Open Enrollment
  • Patient Accounts
  • Insurance Claims
  • Escalate
  • Insurance Benefits
  • Medicare Advantage
  • EOB
  • ICD-9
  • MSP
  • Medical Billing
  • Medical Terminology
  • Telephone Calls
  • Quality Standards
  • B Claims
  • Customer Inquiries
  • Plan Changes
  • MC
  • Telephone Inquiries
  • Medicare HMO
  • Customer Relations
  • RX
  • Appeal Request
  • COB

Updated January 8, 2025

Zippia Research Team
Zippia Team

Editorial Staff

The Zippia Research Team has spent countless hours reviewing resumes, job postings, and government data to determine what goes into getting a job in each phase of life. Professional writers and data scientists comprise the Zippia Research Team.

Updated January 8, 2025

Browse office and administrative jobs