Company: ISO Claims Partners
Posted on: January 15, 2022
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 at---www.verisk.com/claimspartners. 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
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
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
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
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
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
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
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
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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