Sedgwick
By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies
Certified as a Great Place to Work®
Fortune Best Workplaces in Financial Services & Insurance
Sr. Medicare Associate
Job Description
Set up new Medicare Lien Resolution (MLR) referrals in the Medicare Compliance System
Electronically sort and index Medicare mail in the SIR and Medicare Compliance systems
Responds to questions from examiners about Medicare Compliance processes and products
Documents activity in MCS; communicates MCS action with examiner via JURIS notes
Creates daily reports to manage workload and monitors due dates.
Communicates with examiners and defense counsel to resolve technically difficult issues related to obtaining medial records
Assists in training new departmental colleagues
Assists with special client projects as needed.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
QUALIFICATIONS Education & Licensing High school diploma or GED required
Experience One (1) year of general office experience required. Claims or medical records/billing industry experience preferred. Two (2) years of experience as Medicare Associate required. Internal candidates - Minimum 3.25 on most recent performance appraisal.
Skills & Knowledge
Excellent oral and written communication skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Ability to work in a team environment and independently
Ability to meet or exceed Performance Competencies
WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental
:
Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical
:
Computer keyboarding, travel as required
Auditory/Visual
:
Hearing, vision and talking
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.
Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,0️ clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see
sedgwick.com
#J-18808-Ljbffr
Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies
Certified as a Great Place to Work®
Fortune Best Workplaces in Financial Services & Insurance
Sr. Medicare Associate
Job Description
Set up new Medicare Lien Resolution (MLR) referrals in the Medicare Compliance System
Electronically sort and index Medicare mail in the SIR and Medicare Compliance systems
Responds to questions from examiners about Medicare Compliance processes and products
Documents activity in MCS; communicates MCS action with examiner via JURIS notes
Creates daily reports to manage workload and monitors due dates.
Communicates with examiners and defense counsel to resolve technically difficult issues related to obtaining medial records
Assists in training new departmental colleagues
Assists with special client projects as needed.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
QUALIFICATIONS Education & Licensing High school diploma or GED required
Experience One (1) year of general office experience required. Claims or medical records/billing industry experience preferred. Two (2) years of experience as Medicare Associate required. Internal candidates - Minimum 3.25 on most recent performance appraisal.
Skills & Knowledge
Excellent oral and written communication skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Ability to work in a team environment and independently
Ability to meet or exceed Performance Competencies
WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental
:
Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical
:
Computer keyboarding, travel as required
Auditory/Visual
:
Hearing, vision and talking
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.
Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,0️ clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see
sedgwick.com
#J-18808-Ljbffr