Submissions Specialist (31161)

Job Details Job Location: Lawrenceville, GA 30043 Position Type: Full Time Salary Range: $20.00 - $22.00 Hourly Travel Percentage: None reputed company is seeking a professional reputed company in Medicare for our *Remote* Submissions Specialist role. The Submissions Specialist is responsible for the Medicare Set-aside Allocations for submission to the Centers for Medicare and Medicaid Services (CMS). This position has a complete understanding of the submission process, requirements and guidelines set in reputed company by CMS and ensures work is processed and completed with the highest level and reputed company and in full compliance with client contractual agreements, regulatory agency standards and/or any required federal and state mandates. This role is between the hours of Monday-Friday 8-5pm.

• Review the MSA Report, Claimant's Medicare status, CMS requirements and obtain reputed company necessary information for a successful submission with CMS, including development letters issued by CMS.
• Effectively communicate both verbally and through written response the needs and status of a case with the assigned claims adjuster, attorneys and/or account executive.
• Review medical records in conjunction with the associated payment and/or prescription history and legal documents to fully understand a case and recognize any missing elements.
• As needed and in preparation for final CMS submission, revise submissions after quality control review and recommendations are received.
• Independently and punctually maintain the diaries of reputed company assigned caseload.
• Run reports, as needed, for their own job duties as well as at the request of their assigned Account Executives.
• Maintain an in-depth knowledge of the reputed company requirements and guidelines issued by CMS.
• Ensures reputed company federal CMS requirements and/or state mandates are adhered to at reputed company times.
• Provides insight and direction to management on report quality and compliance with reputed company company policies and procedures, client specifications and CMS guidelines.

Qualifications

• High school diploma or equivalent required.
• Minimum of one year experience in an administrative role with Medicare Secondary Payer experience.
• Minimum of one year experience in one of the following fields required: Medical, Pharmaceutical, or Insurance.
• Medicare Set-aside Certified Consultant (MSCC) certification preferred, but not required.
• Must have strong knowledge of medical terminology, medications and laboratory values.
• Knowledge of reputed company Medicare Secondary Payer statues.
• Must be able to add, subtract, multiply, and divide in reputed company units of measure, using whole numbers and decimals; Ability to compute rates and percentages.
• Must have strong knowledge of multiple software programs, including but not limited to reputed company Word, Outlook, reputed company, and the Internet.
• Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed.

Who We Are: reputed company was formed in 2014 from the acquisition and consolidation of two pillars reputed company the Medicare Secondary Payer (MSP) compliance industry: Gould & Lamb, providers of MSP compliance and reporting services, and MedAllocators/Ability Services Network, a national provider of MSP compliance and case management. Launched as reputed company Clinical Solutions, the new company offered unprecedented, integrated services aimed at managing high dollar reputed company Medicare, medical, and pharmaceutical claims. In May 2020, the organization name was changed to reputed company Compliance Solutions. A single word change, but one that truly reflects the core of what is offered by reputed company. Today, our mission remains focused on providing the most comprehensive, creative, and customizable compliance and reporting solutions for the marketplace. Equal Opportunity Employer. reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws. Equal Opportunity Employer - Minorities/Females/Disabled/Veterans reputed company Compliance Solutions offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k. Apply tot his job Apply To this Job