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Sr. Medicare Associate

PRIMARY PURPOSE To gather documentation required to complete Medicare Compliance referrals in a timely manner; to upload referrals to Medicare Compliance System (MCS); to review the pay histories and medical records for adequacy; and to resolve technically difficult record files.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

Reviews JURIS pay ledger as a guide to locate medical records needed for MCS assignment; analyzes additional records to determine if they are pertinent to Medicare Set Aside (MSA); and determines appropriate course of action.
Pulls and sorts medical records required for complex Medicare Compliance referral from appropriate sources; identifies missing document/records; requests missing documentation from provider, examiner and/or defense counsel.
Handles complex records issues by identifying and seeking out critical records to create a file that meets government requirements.
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