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Summary

To function as a subject matter specialist and provide Medicare Secondary Compliance guidance to teammates as well as Workers Compensation and Liability customers.

To gather information and documentation necessary to provide entitlement verifications, Medicare set asides, and conditional payment investigations.

To ensure that all cases are managed within company service standards and industry best practices. To manage audit / exception assignments and work condition reports through completion, to communicate results, and to make recommendations to management.

Essential Duties and Functions

• Coordinates referrals for IMPAXX services on a national basis.
• Provides all parties with information and documentation needed to perform requested service in a timely manner, educates customers on services available and on MSP Compliance, assists in any way possible to ensure quality, timely service delivery and a high level of customer satisfaction.

Accurate Data entry into proprietary application of all referral intake information including customer, claimant demographics, type of services requested, special circumstances or requests.

Types or word processes a variety of materials, including letters, memoranda, charts, interoffice communications, confidential reports, spreadsheets, and other correspondence, as requested by the Process Manager, with responsibility for format, arrangement of attachments, correct spelling, punctuation and grammar.

• Manages and maintains files of documents and records as instructed by the Process Manager ensuring accurate and logical organization of files, maintains confidential files as necessary.
• Receives, screens, and routes incoming telephone calls, resolves routine problems requiring knowledge of department policies and procedures and provides information.
• Provides interpretations of CMS Memorandums on a case-to-case basis to customers. Determines how Medicare’s interest will need to be protected with a WC or liability Settlement.
• Supports team cohesiveness through on-going diplomatic effective written and verbal communication. Supports the goals and philosophy of IMPAXX as a whole.
• Maintains active caseload.
• Works vigorously to earn and keep customer trust.
• Provides customer service to clients by monitoring and resolving customer complaints that are escalated to management.
• Works across teams (Service, Recovery Services and Submissions) to enhance service offerings to meet client needs.
• Continuous improvement mindset. Assesses processes and makes recommendations that streamline and further contribute to operational health .
• Responsible for managing assigned daily / weekly / monthly audit / exception reports
• Responsible for managing assigned Work Condition Report.
• Any other duties as may be assigned.

Qualifications / Requirements

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.

Required Qualifications

• Minimum High School Diploma or equivalent
• Proficient with MS Office Suite
• Exceptional telephone demeanor

Preferred

• Bachelor’s degree from an accredited university or college preferred
• 1 3 years workers compensation experience
• Experience in managing a case load

We are an Equal Opportunity Employer. We take pride in the diversity of our team and seek diversity in our applicants.

Last updated : 2024-05-17