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Global Litigation Consultants
Clearwater, Florida, United States
27 days ago

Description

The Medicare Set-Aside Certified Consultant is responsible for developing reports based upon guidelines provided by the Centers for Medicare and Medicaid Services outlining the future Medicare-covered expenses of individuals whose liability claims are in the settlement process. The consultant will assess individuals with a life-changing injury or illness to determine their future medical needs with associated costs and ensure the client has the necessary funds to be cared for throughout their life. This position will utilize clinical and nursing skills to develop Medical Cost Projections and Medicare Set-Asides for liability settlements based on published standards of practice. The consultant will rely on their medical knowledge to evaluate the patient's treatment plan for future medical treatment needs supporting the goals of the Medicare Services Department.



Requirements

  • Compose a written document that provides a comprehensive, clear, and concise analysis of medical records.
  • Prepare submission of MSA proposal to CMS for review and approval Perform evidenced based medical research regarding unfamiliar diagnoses and future medical needs.
  • Assign CPT coding and pricing to all future Medicare-covered expenses.
  • Assign NDC coding and AWP pricing to all future medication pricing.
  • Clarify need for Rated Age and obtain or calculate life expectancy.
  • Calculate lifetime pricing utilizing state fee schedule or "usual & customary" charges.
  • Required to read extensively and utilize standards of care per current CMS guidelines.
  • Communicate with clients clarifying specific requirements of case.
  • Provide Medicare Secondary Payer compliance education as necessary.
  • Secure, analyze and dispute Medicare conditional payments unrelated to claim/s in settlement process.
  • Required to use telephone extensively.
  • Additional duties as required.


KNOWLEDGE & SKILLS:

  • Effective multi-tasking skills in a high-volume, fast-paced, team-oriented environment.
  • Ability to interface with claims staff, attorneys, physicians and their representatives, and advisors/clients and coworkers.
  • Excellent written and verbal communication skills.
  • Ability to meet designated deadlines.
  • Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets.
  • Strong interpersonal, time management and organizational skills.
  • Ability to work both independently and within a team environment.

Job Information

  • Job ID: 59651922
  • Location:
    Clearwater, Florida, United States
  • Position Title: Medicare Set-Aside Consultant
  • Company Name: Global Litigation Consultants
  • Practice Area: Medical legal support
  • Job Type: Full-Time
  • Job Duration: Indefinite
  • Min Education: Associates Degree
  • Min Experience: 3-5 Years
  • Required Travel: 0-10%

Please refer to the company's website or job descriptions to learn more about them.

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