Medicare Set Aside (MSA) Specialist - Part-Time - REMOTE (KY)
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Louisville, KY, US
Company:
EK Health Services Inc specializes in Medicare Set-Aside allocations and compliance solutions.
Summary:
The MSA Specialist evaluates, prepares, and submits Medicare Set-Aside allocations. Previous MSA experience and knowledge of relevant CMS guidelines are essential.
Requirements:
Hard Skills: Medicare Secondary Payer Act knowledge, Medical record interpretation, MSA allocation expertise
Experience: 2+ years of experience in workers’ compensation, liability claims, medical case management, or Medicare compliance.
Job Description:
Reporting to the President, the Medicare Set-Aside (MSA) Specialist is responsible for evaluating, preparing, and submitting Medicare Set-Aside allocations in compliance with CMS guidelines and applicable state and federal regulations. This role ensures the protection of Medicare’s interests in workers’ compensation and liability settlements, collaborating with internal teams, clients, legal counsel, and medical professionals to deliver compliant, timely, and accurate MSA reports.
Position Specifics: Non-Exempt position working Part-Time Monday through Friday, in office or remotely.
Please NOTE: This position requires previous Medicare Set-Aside experience.
Key Responsibilities
- Review and edit initial medical abstraction and MSA future medical allocation to ensure the MSA allocation meets both quality standards and client expectations. Includes review of medical records, billing statements, case notes, and pharmacy histories to develop accurate MSA allocation.
- Analyze and apply CMS guidelines, statutes, and state regulations related to Medicare Secondary Payer compliance.
- Support CMS Submission Specialists to ensure MSA packages are prepared accurately for submission to CMS. Requires detailed understanding of all CMS submission requirements, including workload thresholds and settlement details.
- Communicate with claims professionals, legal teams, and clients to gather necessary data for both case completion and case resolution.
- Stay current on CMS policy changes and industry trends to ensure ongoing compliance and best practices.
- Respond to client inquiries and provide expert guidance on MSA processes, pricing, and submission requirements.
- Coordinate conditional payment searches, lien resolution, and related Medicare compliance services as needed.
- Maintain accurate documentation and records in accordance with organizational and regulatory requirements.
Benefits
- Base hourly rate
- Medical, Dental, Vision Insurance
- 401K
- Paid Time Off
- Paid Holidays
- Equipment provided
- Monthly internet stipend
