CMSP Certification is strongly preferred., Minimum of 2+ years of experience in MSP services, including Medicare compliance and appeals., Strong analytical, communication, and time management skills are essential., Proficiency in Microsoft Office and ability to work independently..
Key responsabilities:
Oversee the Medicare Secondary Compliance Team and daily department operations.
Develop internal procedures, processes, and training materials for the team.
Perform quality assurance on reports, disputes, appeals, and submissions.
Manage client relations through meetings and calls, ensuring compliance with deadlines.
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Ethos Risk Services is a technology-backed, full-service claims management company. We bring clarity to a world of uncertainty through investigation and verification resources aimed at delivering optimal solutions to our clients. Services include surveillance, OSINT/digital investigations, SIU, and claims investigations. We also provide a full suite of medical management solutions that includes utilization management, field case management, IME, bill review, and Medicare services (MSP).
Our coverage includes all 50 states and over 80 countries. We are SOC 2 Type 2 and HIPAA compliant.
Our vision is to be the most tech-enabled, customer-centric claim management company that makes verification a matter of certainty.
You want to be sure your claims are verified with all the facts. To do that you need all the facts, and delays increase costs. That’s why we’ve developed the technology and training to keep your claims on track for optimal outcomes. With our solutions you’ll save time and money with the peace of mind of having 100% surety.
More Coverage. More Accountability. More Consistency.
Ethos Risk Services is a leading insurance claims investigation and medical management company committed to providing better data that translates into better decision-making for our clients. We are at the forefront of innovation in our space, and our success is driven by a dynamic team passionate about delivering exceptional services to our customers.
Job Summary
Our dynamic Ethos Risk Services is seeking a full-time MSP Services Administrator (REMOTE) to join our Medical Management division. Our ideal candidate has strong MSP experience to oversee the daily operations of our Medicare Secondary Compliance Team. This role ensures the timely and accurate completion of referrals and Medicare filings while maintaining compliance with all regulations.
Key Responsibilities
Oversee the Medicare Secondary Compliance Team and daily department operations.
Develop internal procedures, processes, and training materials.
Perform QA on reports, disputes/appeals, and submissions.
Manage the CMS WCMSA and MSPRP Portals.
Monitor CMS alerts and updates.
Maintain accuracy of the MSP log and track pending timelines.
Handle client relations, including meetings and calls.
Ensure compliance with state and federal deadlines.
Maintain confidentiality and security.
Qualifications
Certifications:
CMSP Certification (strongly preferred).
Experience/Skills
Minimum of 2+ years of experience in MSP services (such as Medicare compliance, submissions, and appeals)
Knowledge of medical terminology, diagnoses, and procedures
Strong analytical, communication, and time management skills
Proficiency in Microsoft Office and ability to work independently
WORKING CONDITIONS
This role is 100% remote (US hours). Constant communication via telephone and virtual platforms with clients, customers, and co-workers. Office environment or home office with constant temperatures. Prolonged periods of stationary positioning.
Ethos Risk Services is an equal opportunity employer that does not discriminate on the basis of religious creed, sex, national origin, race, veteran status, disability, age, marital status, color or sexual orientation or any other characteristic protected by law.
Salary: $55000 - $65000 per year
Job Posted by ApplicantPro
Required profile
Experience
Industry :
Insurance
Spoken language(s):
English
Check out the description to know which languages are mandatory.