Medicare Compliance Coordinator

Sedgwick

2d • Onsite

About The Position

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance. The Medicare Compliance Coordinator's primary purpose is to gather documentation required to complete Medicare compliance referrals in a timely manner; to upload referrals to Medicare Compliance System (MCS); and to handle incoming mail. We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.

Requirements

• High school diploma or GED required.
• One (1) year of general office experience or equivalent combination of education and experience required.
• Excellent oral and written communication 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

Nice To Haves

• Claims or medical records/billing industry experience preferred.

Responsibilities

• Pulls and sorts medical records required for Medicare compliance referral from appropriate sources; identifies missing documents/records; requests missing documentation from provider, examiner and/or defense counsel.
• Analyzes and submits medical records to nurses to enable them to complete referral in a timely manner; uploads referrals and reports from claims system into Medicare Compliance System (MCS); ensures MCS is updated properly.
• Analyzes pay ledger as a guide to locate medical records needed for MCS assignment; analyzes additional records to determine if they are pertinent to Medicare Set Aside (MSA) and determines appropriate course of action.
• Documents records handler activity in MCS; communicates MCS action with examiner via JURIS notes.
• Responds to questions from examiners about Medicare compliance processes and products.
• Maintains professional client relationships.
• Sorts available records in DOS order.
• Processes mail.
• Performs other duties as assigned.
• Supports the organization's quality program(s).

Benefits

• Three Medical, and two dental plans to choose from.
• Tuition reimbursement eligible.
• 401K plan that matches 50% on every $ you put in up to the first 6% you save.
• 4 weeks PTO your first full year.
• medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED