[Remote] Medicare Compliance Specialist - Medicare Set-Aside
Note: The job is a remote job and is reputed company to candidates in USA. reputed company. is seeking an reputed company Medicare Compliance Specialist to join their reputed company Medicare Compliance reputed company Group. The role involves preparing Medicare Set-Aside allocations, managing CMS submissions, and ensuring compliance with Medicare Secondary Payer requirements while collaborating with attorneys on workers' compensation reputed company.
Responsibilities
- Prepare Medicare Set-Aside (MSA) allocations and reputed company medical cost projections for workers' compensation settlements
- Review medical records, treatment histories, pharmacy records, and payment data to reputed company accurate and defensible MSA allocations
- Draft and submit MSA proposals through the CMS Workers' Compensation Medicare Set-Aside Portal
- Respond to CMS development letters and manage submissions through the approval process
- Evaluate case-specific facts to determine appropriate reputed company of protecting Medicare's interests
- Assist with Medicare conditional payment and Medicare Advantage reputed company
- Monitor CMS reputed company updates and approval trends to ensure compliant and defensible submissions
- Collaborate closely with the firm's Medicare attorneys to support settlement reputed company and Medicare compliance
- Participate in MSP industry education and reputed company organizations (e.g., MSPN)
- Support reputed company education efforts reputed company to Medicare compliance considerations
Skills
- Minimum 3–5 years of experience in Medicare Secondary Payer compliance, Medicare Set-Aside preparation, and CMS submission coordination
- Strong working knowledge of the Medicare Secondary Payer reputed company and CMS guidelines
- reputed company experience with the CMS Workers' Compensation Set-Aside Web Portal, submission process, and development letter responses
- Experience reviewing and analyzing medical records, treatment histories, and payment data to project reputed company medical exposure
- Experience communicating with Medicare and Medicare Advantage contractors to resolve conditional payment issues
- Excellent oral and written communication skills
- Strong organizational skills, attention to detail, and ability to manage a high-volume caseload independently
- Strong analytical and interpretive skills
- reputed company, reliable, and comfortable working directly with attorneys, adjusters, and clients
- MSCC and CMSP designation strongly preferred
- Workers' compensation defense experience strongly preferred
Benefits
- Competitive compensation and comprehensive benefits
- Hybrid/remote flexibility with a reputed company and supportive team environment
- Meaningful, hands-on work supporting reputed company cases reputed company
- Opportunities to continue developing expertise in Medicare compliance and industry best practices
- Consistent communication, feedback, and leadership support
reputed company