MSA Compliance and Medical Review Specialist

June 12

🐊 Florida – Remote

Although this job is listed in Florida, this company may be open to hiring remote in other states.

💵 $55k - $90k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔍🏥 Medical Reviewer

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Brown & Brown Insurance

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Brown & Brown Insurance is one of the largest independent insurance brokerages globally, providing innovative insurance solutions and risk management services to protect the personal and business assets of its clients. Established in 1939 and publicly traded since 1993, Brown & Brown has grown through a disciplined strategy of acquiring culturally and financially suitable companies. With a strong emphasis on diversity, inclusion, and belonging, the company fosters a unique culture that rewards self-starters and focuses on delivering exceptional service through its 500+ locations worldwide.

Property & Casualty Insurance • Employee Benefits • Personal Lines

10,000+ employees

Founded 1939

🏢 Enterprise

📋 Description

• Prepares future medical cost projections and Medicare Set-aside Allocation reports. • Interacts regularly with customers providing excellent customer service. • Communicates daily with internal teams at IMPAXX. • Reviews and analyzes medical records, claim file documents, hearing orders, and depositions for preparation of allocation reports. • Researches Medicare coverage, jurisdictional, and regulatory guidelines. • Communicates frequently and effectively with Team Leader, Coding Team, Clinical Director, and Referral Coordinators. • Reviews resources on the Analyst iPortal and IMPAXX Intranet frequently, including customer handling instructions. • Ensures thorough and accurate file documentation including data entered into MyConnect. • Prepares future medical cost projections and Medicare Set-aside Allocation reports. • Responsible for data entry into the medical tab for development of allocation preparation. • Communicates with customer as needed for clarification of outstanding information needed to complete the allocation report requested. • Provides rationale for allocation and identify mitigation opportunities. • Reviews auto-MyConnect pricing function to ensure accuracy. • Proofreads both calculation and summary generated. • Provides feedback for possible improvements to workflow processes within the MyConnect system. • Delivery of allocation report to customer identifying exposure and mitigation opportunities. • Responds to direct inquiries from customer regarding delivered allocations or other MSP compliance questions from customer or facilitate the direction to the appropriate team. • Reviews, analyzes, and communicates CMS counter opinions as assigned. • Produce a minimum of 1.2 allocation reports per day based on a fiscal month end average. • Maintains confidentiality and security of all medical records received and reviewed. • Any other duties as may be assigned.

🎯 Requirements

• 3-5 years of experience with Workers’ Compensation or Liability claims • Proficiency with MS Office Suite • Accurate typing skills and proficiency • Excellent telephone demeanor • Ability to work additional hours or a flexible schedule based on occasional increased work demands • One of the following (multiple areas preferred): • Bachelor Degree (preferred) • Juris Doctorate (JD) • Bachelor Degree Nursing, Registered Nurse (RN) License with 3-5 years clinical nursing experience • Paralegal Certificate • Claims management experience – three to five years • MSA Analyst experience

🏖️ Benefits

• Health Benefits : Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance • Financial Benefits : ESPP; 401k; Student Loan Assistance; Tuition Reimbursement • Mental Health & Wellness : Free Mental Health & Enhanced Advocacy Services • Beyond Benefits : Paid Time Off, Holidays, Preferred Partner Discounts and more.