CMS Submission Coordinator

Brown & Brown Insurance

2d•$20 - $25

About The Position

IMPAXX, a Medicare compliance company supporting the Property/Casualty industry, is seeking a CMS Submission Coordinator. The company provides nationwide settlement and compliance solutions for workers’ compensation and liability claims involving bodily injury, including Medicare Set-Aside arrangements, MSA administration, lien resolution, structured settlements, and Mandatory Insurer Reporting. The CMS Submission Coordinator serves as a liaison among insurers, third-party administrators, attorneys, and Medicare throughout the CMS submission process. The role manages assigned non-complex submissions, reviews and interprets Medicare correspondence and requests, communicates requirements to customers, and helps ensure responses are timely and accurate. It requires strong communication and customer service skills, attention to detail, and an understanding of the Medicare submission process and review thresholds.

Requirements

High school diploma or equivalent.
Basic working knowledge of Microsoft Outlook, Word, Excel, and PDF software.
Exceptional telephone etiquette and strong written and verbal communication skills.
Ability to perform the essential duties of the position satisfactorily, with reasonable accommodation when applicable.
Ability to maintain confidentiality and appropriately safeguard sensitive information.

Nice To Haves

Bachelor’s degree from an accredited university or college.
Working knowledge of Medicare guidelines and Medicare Secondary Payer compliance statutes.
One to three years of experience in workers’ compensation.
Experience managing a caseload.

Responsibilities

Serve as the primary contact for assigned non-complex CMS submissions and identify and escalate complex requests as appropriate.
Review submission files proactively to confirm receipt of required documentation and information.
Analyze Medicare requests and clearly communicate required information and next steps to customers by email and phone.
Evaluate development response documentation against Medicare’s requests and communicate anticipated additional requirements to customers.
Notify customers of incoming Medicare correspondence within established turnaround times.
Respond promptly and professionally to customer calls and emails, addressing questions and concerns throughout the submission process.
Communicate CMS submission processes, review thresholds, and relevant product delivery considerations to customers.
Engage with Medicare and its contractors to obtain answers to case-specific questions when necessary.
Coordinate additional assessments with other IMPAXX teams and collaborate across teams to meet customer needs and internal service standards.
Monitor CMS trends and share relevant information with teammates and customers.
Review assigned exception reports and prepare a daily Work Condition Report.
Escalate customer concerns to the Team Leader, CMS Submissions for review and resolution.
Cross-train with teammates in similar roles to provide backup support as needed.
Maintain customer trust through timely, diplomatic, professional, and effective communication.
Adhere to company confidentiality policies and procedures, safeguarding sensitive information.
Perform other duties as assigned.