Note: The job is a remote job and is open to candidates in USA. Allan Koba Compliance Solutions is seeking an experienced Clinical Specialist to join their team. The role involves writing Medicare Set-Aside allocations and requires familiarity with Medicare Secondary Payer matters, workers’ compensation, and liability insurance.
Responsibilities
- Mastery of the Workers’ Compensation Medicare Set-Aside Reference Guide
- Current understanding of trending with the Workers’ Compensation Review Contractor
- Competence in writing Medicare Set-Asides for the purpose of CMS submission
- Experience in writing Evidence Based Medicare MSAs for non-submission
- Excellent writing, organizational and communication skills
- Knowledge of state fee schedule pricing methodology
- Familiarity with usual and customary pricing methodology
- Knowledge of Redbook and alternative pharmacy pricing methodology
- Ability to independently handle multiple priorities and deadlines with minimal supervision while simultaneously functioning smoothly in a fast-paced, close-knit environment
- Ability to manage multiple tasks
- Proficient in Microsoft Office Suite, Word and Excel
- Ability to allocate pursuant to client-specific protocols and methodologies
- Responsible for successful file management, problem solving and client satisfaction
- Resolve and troubleshoot issues, requiring subject matter knowledge and understanding of company policies and procedures
Skills
- Mastery of the Workers' Compensation Medicare Set-Aside Reference Guide
- Current understanding of trending with the Workers' Compensation Review Contractor
- Competence in writing Medicare Set-Asides for the purpose of CMS submission
- Experience in writing Evidence Based Medicare MSAs for non-submission
- Excellent writing, organizational and communication skills
- Knowledge of state fee schedule pricing methodology
- Familiarity with usual and customary pricing methodology
- Knowledge of Redbook and alternative pharmacy pricing methodology
- Ability to independently handle multiple priorities and deadlines with minimal supervision while simultaneously functioning smoothly in a fast-paced, close-knit environment
- Ability to manage multiple tasks
- Proficient in Microsoft Office Suite, Word and Excel
- Ability to allocate pursuant to client-specific protocols and methodologies
- Responsible for successful file management, problem solving and client satisfaction
- Resolve and troubleshoot issues, requiring subject matter knowledge and understanding of company policies and procedures
- Bachelor's degree
- Active nursing license
- Experience in writing Medicare Set-Aside allocations
- Familiarity with Medicare Secondary Payer matters
- Experience in workers' compensation and/or liability insurance
Benefits
- Excellent benefits including medical, dental, vision, life insurance and 401(K) with match.
Company Overview