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MSP Coordinator

Company: ISO Claims Partners
Location: Bradenton
Posted on: January 15, 2022

Job Description:

Company Description

ISO Claims Partners, a Verisk business, is a nationally recognized leader in providing cost-effective and proven Medicare compliance and claim analytics services for Workers' Compensation, First-Party No-Fault, and Liability claims. For the past two decades we have been a trusted consultant and provider to the largest carriers, TPAs, and self-insured Fortune 1000 companies in the world. We draw on unique data assets and deep domain expertise to develop products and services designed with one goal in mind: improving claims outcomes throughout the life of a claim. We accomplish this by providing cutting-edge analytics, unmatched data, and superior medical and legal advocacy - with big payoffs, taking claims organizations from a reactive to a proactive approach. ISO Claims Partners is headquartered in North Reading, Massachusetts, and has offices throughout North America. To learn more about ISO Claims Partners, please visit us We are proud to be a part of the Verisk family of companies!

At the heart of what we do is help clients manage risk. Verisk (Nasdaq: VRSK) provides data and insights to our customers in insurance, energy and the financial services markets so they can make faster and more informed decisions.

Our global team uses AI, machine learning, automation, and other emerging technologies to collect and analyze billions of records. We provide advanced decision-support to prevent credit, lending, and cyber risks. In addition, we monitor and advise companies on complex global matters such as climate change, catastrophes, and geopolitical issues.

But why we do our work is what sets us apart. It stems from a commitment to making the world better, safer and stronger.

It's the reason Verisk is part of the UN Global Compact sustainability initiative. It's why we made a commitment to balancing 100 percent of our carbon emissions. It's the aim of our "returnship" program for experienced professionals rejoining the workforce after time away. And, it's what drives our annual Innovation Day, where we identify our next first-to-market innovations to solve our customers' problems.

At its core, Verisk uses data to minimize risk and maximize value. But far bigger, is why we do what we do.

At Verisk you can build an exciting career with meaningful work; create positive and lasting impact on business; and find the support, coaching, and training you need to advance your career.---We have received the Great Place to Work - Certification for the fifth consecutive year. We've been recognized by Forbes as a World's Best Employer and a Best Employer for Women, testaments to our culture of engagement and the value we place on an inclusive and diverse workforce. Verisk's Statement on Racial Equity and Diversity supports our commitment to these values and affecting positive and lasting change in the communities where we live and work.

Job Description

The MSP (Medicare Secondary Payer) Coordinator guides and manages the claim/service though all appropriate steps in order to complete the requested service or request. The MSP Coordinator will work hand in hand with the Coordination of Benefits (COBC), Medicare Secondary Payer Recovery Contractor (MSPRC), Social Security Administration Offices, Department of Treasury and any of their agents as needed in order to complete each service. The Coordinator will be accountable for all activities and claims within their assigned work queues for the client, utilize their customer service and MSP Compliance skills, as well as, company policies and procedures while moving their claims from receipt to completion. They will need to effectively identify and escalate potential customer issues to the MSP Director. Communication with internal departments, field sales, and staff, as well as external customer organizations is essential. Reporting to management weekly on production completed, projections and inhibitors.

About The Day To Day Responsibilities Of The Role
Researching and obtaining Medicare and Social Security entitlement information
Completing COBC notifications
Conditional Payment Research, evaluation of ICD-9 codes and unrelated charges, disputes/negotiations and securing the final demand or closure information as dictated by service requested
Keep turn-around times at levels to maintain a competitive advantage and exceed customer expectations
Engage CMS, COBC, MSPRC and SSA in appropriate communication that manages client expectations and builds a collaborative relationship with the other agencies.
Researches and Analyzes the claim and all relevant information prior to initiating any work on the service
Maintains complete records on all claims/services including, but not limited to, detailed documentation on all claim activity
Generates correspondence through the use of system letters, faxes, free form letters, and email communication.
All correspondence must be communicated with utmost professionalism and pride
Follows company processes and procedures at all times
Interacts well and communicates confidently with individuals at all levels of an organization
Identify and pursue via escalation to MSP Director the development of documents needed for claim/service
Utilize Internet and Intranet resources for policy verification and state regulations
Utilize and knowledge of shared system access to the MSPRC AND CMS Portals to verify & obtain claim status updates, request updated or final demand conditional payment information, upload new documents, and submit submissions for WCRC review.
Direct requests and unresolved issues to the designated resource or MSP Director
Complete tasks and follow up by expected due dates.
Works independently to keep abreast of technical MSP statute compliance requirements and changes
Other various duties, at the discretion of direct management

Working knowledge of Medicare Secondary Payer (MSP) Statute
Prefer having knowledge of Conditional Payment Lien Research, Dispute/Negotiations of Conditional Payments and securing the final demand amount.
Knowledge of Internet and email procedures
Strong time management skills
Able to meet deadlines as provided by Client and Management
Ability to read and interpret documents, such as procedure manuals, invoices, and company literature
Knowledge of medical terminology preferred
Knowledge of Word, Excel and PowerPoint programs
Quality grammatical typing skills
Works well in team driven environment
Exceptional professional face to face and telephone demeanor
Ability to maintain a high level of confidentiality
Knowledge of SSDI, rehabilitation, disability (STD & LTD), medical and workers' compensation benefits
High School Diploma required

Additional Information

Verisk Analytics is an equal opportunity employer.

All members of the Verisk Analytics family of companies are equal opportunity employers. We consider all qualified applicants for employment without regard to race, religion, color, national origin, citizenship, sex, gender identity and/or expression, sexual orientation, veteran's status, age or disability.

Unsolicited resumes sent to Verisk, including unsolicited resumes sent to a Verisk business mailing address, fax machine or email address, or directly to Verisk employees, will be considered Verisk property. Verisk will NOT pay a fee for any placement resulting from the receipt of an unsolicited resume.

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Keywords: ISO Claims Partners, Bradenton , MSP Coordinator, Other , Bradenton, Florida

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