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Medicare Compliance Assistant

Company: Sedgwick Claims Management Services, Inc
Location: Richmond
Posted on: January 12, 2021

Job Description:

Medicare Compliance AssistantIF YOU CARE, THERE'S A PLACE FOR YOU HEREFor a career path that is both challenging and rewarding, join Sedgwick's talented team of 21,000 colleagues around the globe. Sedgwick is a leading provider of technology-enabled risk, benefits and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. Whether they have a workplace injury, suffer property or financial loss or damage from a natural or manmade disaster, are involved in an auto or other type of accident, or need time away from work for the birth of a child or another medical situation, we are here to provide compassionate care and expert guidance. Our clients depend on our talented colleagues to take care of their most valuable assets -- their employees, their customers and their property. At Sedgwick, caring counts--. Join our team of creative and caring people of all backgrounds, and help us make a difference in the lives of others.Sedgwick's Medicare compliance team assists clients with Medicare Set-Asides (MSAs) and Medicare liens, which can impact workers' compensation and general, professional and auto liability claims. MSAs are reports created with the purpose of protecting Medicare's future interest in the event of a settlement. Our examiners use MSAs to negotiate settlements and the amount should provide funds for the claimant to treat their injury post settlement. We also assist with Medicare liens, which include any payments made by Medicare for the benefit of a claimant/plaintiff between the injury date and the settlement date. Our team reviews the liens for accuracy and handles any necessary negotiations to reduce them prior to settlement.PRIMARY PURPOSE: To provide specialized unit support including updating of non-technical key data fields in JURIS/Source/Ovation systems for Medicare Compliance Team; to monitor field office corrections of technical key data fields; and to provide general data integrity support activities.ESSENTIAL FUNCTIONS and RESPONSIBILITIES* Communicates with operations concerning MMSEA issues; provides field support for MMSEA compliance.* Monitors field compliance on key technical data for MMSEA Section 111 reporting.* Generates, reviews and identifies issues in reports related to MMSEA compliance.* Enters and maintains systems data as required.* Answers examiner questions related to Medicare Compliance issues (MMSEA, MSA and Medicare liens).ADDITIONAL FUNCTIONS and RESPONSIBILITIES* Performs other duties as assigned.* Supports the organization's quality program(s).QUALIFICATIONSEducation & LicensingHigh school diploma or GED required.ExperienceOne (1) year experience in office administration or one (1) one year of claims handling experience or equivalent combination of experience and education required. Experience with an insurance company, TPA, broker or consultant preferred. Proficiency in JURIS preferred.Skills & Knowledge* Excellent oral and written communication, including presentation skills * PC literate, including Microsoft Office products * Analytical and interpretive skills * Strong organizational skills * Good interpersonal skills * Ability to work in a team environment * Ability to meet or exceed Performance Competencies WORK ENVIRONMENTWhen applicable and appropriate, consideration will be given to reasonable accommodations.Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlinesPhysical: Computer keyboarding, travel as requiredAuditory/Visual: Hearing, vision and talkingThe statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.Sedgwick--is an Equal Opportunity Employerand aDrug-Free Workplace

Keywords: Sedgwick Claims Management Services, Inc, Richmond , Medicare Compliance Assistant, Other , Richmond, Virginia

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