Planner (32766)

EXAMWORKS COMPLIANCE SOLUTIONS LLC•Lawrenceville, GA

69d•Remote

About The Position

Are you a detail-oriented analyst looking for a high-autonomy, work-from-home role? Join our team as a Remote Medicare Set-Aside (MSA) Planner. In this position, you will work independently from your home office to analyze complex medical records, forecast future healthcare needs, and craft critical MSA Allocations. You will act as a trusted expert, collaborating virtually with attorneys, accounts, and internal teams to deliver high-quality, compliant reports.

Requirements

Minimum of 1 year of direct experience writing Medicare Set-Asides (MSAs).
Strong knowledge of the disability and workers' compensation industry, with a deep understanding of Medicare rules and regulations.
Proficiency with modern digital tools, including Microsoft Office (Word, Outlook, Excel) and web-based research.
Exceptional English verbal and written skills, with a sharp eye for grammar, punctuation, and style.
A proven ability to work independently, prioritize heavy workloads, multitask under pressure, and manage unexpected changes smoothly.
Absolute commitment to data confidentiality, reliability, and fostering a positive, team-oriented environment.
Must be able to adequately operate a general computer, fax, copier, scanner, and telephone.
Must have adequate knowledge of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
Ability to demonstrate critical thinking and problem solving skills.
Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed.
Must be able to work independently, prioritize work activities and use time efficiently.
Ability to concentrate and multitask in a fast paced work environment.
Demonstrates accuracy and thoroughness.
Looks for ways to improve and promote quality and monitors own work to ensure quality is met.
Must be able to maintain confidentiality.
Must be able to demonstrate and promote a positive team -oriented environment.
Must be able to work well under pressure and/or stressful conditions.
Must possess the ability to manage change, delays, or unexpected events appropriately.
Must possess excellent skills in English usage, grammar, punctuation and style.

Nice To Haves

Associate degree or equivalent professional certification.
1+ years of experience in workers' compensation or medical case management.
Active unrestricted Nursing license (including but not limited to RN, NP LVN, LPN).
Active unrestricted Adjuster license.
Certification in Medicare Set Asides and/or certifications in Life Care Planning or Legal Nurse Consulting.

Responsibilities

Review comprehensive health data and medical records to project future medical needs using established medical standards of care.
Protect client interests by aligning all reports with federal CMS requirements, state mandates, and URAC guidelines.
Partner directly with legal teams, accounts, and internal management to communicate findings and provide regulatory insight.
Maintain top-tier quality scores by utilizing exceptional critical thinking, problem-solving, and analytical skills.
Participate in virtual orientation, training sessions, and strategic management meetings to stay ahead of industry changes.