RN Medicare Compliance Sr

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.

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RN Medicare Compliance Sr

PRIMARY PURPOSE OF THE ROLE: To perform provider outreach, specialized document review, and analysis and interpretation of interventions for the preparation of Medicare Set-Aside allocations.

ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.

• Apply your nursing or rehabilitation knowledge and experience to assist in the management of complex medical conditions, treatment planning and recovery from illness or injury.

• Work in the best of both worlds - a rewarding career making an impact on the health and lives of others, and a remote work environment.

• Enjoy flexibility and autonomy in your daily work, your location, and your career path while advocating for the most effective and efficient medical treatment for injured employees in a non-traditional setting. 

• Enable our Caring counts® mission supporting injured employees from some of the world’s best brands and organizations. 

• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. 

• Celebrate your career achievements and each other through professional development opportunities, continuing education credits, team building initiatives and more. 

• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. 

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Contacts providers and attorneys to obtain clarification of documentation needed to support the preparation of Medicare Set-Aside allocations.

• Creates customized correspondence for any applicable providers that will provide the clarity needed to proceed with the preparation of the Medicare Set-Aside.

• Executes outreach activities with providers for each case via telephone, email, and fax, adhering to best practice guidelines. 

• Reviews and analyzes completed documentation from providers to ensure accuracy, completeness, adherence to quality assurance standards.

• Determine the outcome of involvement to include efficacy of response, financial, and client satisfaction.

• Maintains accurate record of management including costs savings.

• Articulates and effectively documents clear and concise information.

EDUCATION AND LICENSING

Bachelor's degree from an accredited college or university preferred.  Active unrestricted RN license issued in a state or territory of the United States required.

​TAKING CARE OF YOU BY

• Thrives when allowed flexibility & autonomy.

• Wants dynamic company culture.

• Passionate about creativity.

• Craves culture of support, both giving and receiving.

• Thrives when everyone is working towards same vision/goals.

• Strong team and customer service orientation.

• Seeks clear role expectations.

• Wants to e valued as a collective 'we'.

• ​We offer a diverse and comprehensive benefits including medical, dental vision, 401K, PTO and more beginning your first day.

NEXT STEPS

If your application is selected to advance to the next round,  recruiter will be in touch.

#nurse #medicare #medicaresetaside

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $$80,000-$86,000.  A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

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.