Note: The job is a remote job and is open to candidates in USA. Brown & Brown's IMPAXX is a Medicare compliance company supporting the property and casualty industry, particularly workers' compensation and liability claim settlements. The MSA Solutions Analyst prepares future medical cost projections and Medicare Set-Aside Allocation reports, analyzes complex claim and medical information, researches Medicare and jurisdictional requirements, and supports customers and internal teams.
Responsibilities
- Review and analyze medical records, claim file documents, hearing orders, and depositions to prepare allocation reports
- Prepare future medical cost projections and Medicare Set-Aside Allocation reports
- Research Medicare coverage requirements, Medicare Secondary Payer statutes, jurisdictional requirements, regulatory guidelines, medical treatment protocols, and associated costs
- Enter accurate and complete information into the medical tab and other applicable areas of MyConnect
- Develop clear rationales for allocations and identify potential mitigation opportunities
- Review MyConnect’s automated pricing results for accuracy and proofread calculations and report summaries
- Maintain thorough and accurate file documentation, including information entered into MyConnect
- Deliver completed allocation reports to customers and clearly communicate identified exposure and mitigation opportunities
- Contact customers as needed to clarify or obtain outstanding information required to complete requested reports
- Respond to customer questions regarding delivered allocations and Medicare Secondary Payer compliance, or direct inquiries to the appropriate internal team
- Review, analyze, and communicate CMS counter opinions as assigned
- Collaborate frequently with the Team Leader, Coding Team, Clinical Director, Referral Coordinators, and other internal IMPAXX teams
- Review resources available through the Analyst iPortal and IMPAXX Intranet, including customer-specific handling instructions
- Provide feedback on potential improvements to MyConnect workflows and related processes
- Produce a minimum average of 1.2 allocation reports per day, measured at fiscal month-end
- Maintain the confidentiality and security of all medical records and other sensitive information received or reviewed
- Perform other duties as assigned
Skills
- Three to five years of experience with workers' compensation or liability claims
- At least one relevant educational or professional background, including a Juris Doctor degree, a paralegal certificate, claims management experience, MSA Analyst experience, or a bachelor's degree in nursing with an active Registered Nurse license and three to five years of clinical nursing experience
- Strong analytical and critical-thinking skills, including the ability to evaluate claim files and medical records and project appropriate treatment protocols and costs
- Ability to research and interpret Medicare guidelines, Medicare Secondary Payer statutes, jurisdictional requirements, medical terminology, and regulatory communications
- Proficiency in basic mathematics, including percentages and fractions
- Strong reading comprehension and the ability to process high volumes of detailed information
- Excellent written communication, proofreading, grammar, and numerical presentation skills
- Strong attention to detail, sound judgment, and the ability to work independently with limited supervision
- Demonstrated accuracy, organization, time management, adaptability, collaboration, and problem-solving skills
- Proficiency with Microsoft Office Suite and accurate typing and data-entry skills
- Professional telephone and customer-service skills
- Ability to maintain confidentiality and protect sensitive medical information
- Ability to work additional hours or a flexible schedule when occasional business demands require it
- Ability to perform the essential functions of the position with or without reasonable accommodation
- Bachelor's degree
- Experience or credentials in multiple relevant areas listed in the qualifications
Benefits
- Medical/Rx
- Dental
- Vision
- Life Insurance
- Disability Insurance
- ESPP
- 401k
- Student Loan Assistance
- Tuition Reimbursement
- Free Mental Health & Enhanced Advocacy Services
- Paid Time Off
- Holidays
- Preferred Partner Discounts
Company Overview