Submissions Specialist (32906)
Posted
ECS is seeking a professional experienced 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 place by CMS and ensures work is processed and completed with the highest level and integrity 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 all 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 all 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 current requirements and guidelines issued by CMS.
-
Ensures all federal CMS requirements and/or state mandates are adhered to at all times.
-
Provides insight and direction to management on report quality and compliance with all company policies and procedures, client specifications and CMS guidelines.