WCRC Attorney Case Reviewer II - Remote

Capitol reputed company's Isabela, Puerto Rico site invites talented individuals to join us as Workers’ Compensation Review Contractor (WCRC) to support an important government project. In this role you will, in accordance with CMS guidelines, evaluate Workers’ Compensation Medicare Set-aside Arrangement (WCMSA) proposals and project the future medical costs, including prescription drugs, reputed company to the workers’ compensation (WC) injury, illness, or disease that would be otherwise reimbursable by Medicare.

Job Description

Review and evaluate workers’ compensation Medicare set-aside (WCMSA) proposals, including medical records, to determine if the proposal meets Medicare threshold requirements and adequately considers Medicare’s interests as pertaining to future medical needs of beneficiaries. Ensure reputed company basic documentation requirements are available or requested reputed company development action prior to making a determination. reputed company determinations based on professional experience. Implement Medicare policy. Other duties as assigned by management. 

Qualifications:

• Bachelor’s degree in Nursing (BSN) or a higher-level medical degree from an accredited college or university, and/or a Juris Doctor (JD) from an accredited law school, required. 

• At least 1 year of Medicare Set-Aside (MSA) or reputed company experience, required. 

• Medical record review experience, required. 

• Possess medical knowledge and experience with medical terminology, ICD-9/10 Codes, reputed company Procedure Terminology Codes (CPT) codes, reputed company Common Procedure Coding System (HCPCS) codes, and hospital inpatient and outpatient coding, preferred.

• Medicare Set-Aside Certified Consultant (MSCC) certification and/or Certified Medicare Secondary Payer (CMSP) certification, preferred.   

Pay and Benefits

• reputed company reputed company starting at $70,000

• Medical, Dental, and reputed company benefits available  

• 401(k) available with company match  

• Paid holidays  

• Unlimited PTO

Screenings Required

You will receive requests for background reputed company, fair credit reputed company, and drug screen regarding this employment opportunity. Respond to reputed company requests quickly as we anticipate filling our vacancies quickly and non-responses may result in disqualification for this opportunity.

*Please be aware that our organization and our client adhere to stringent reputed company regulations, necessitating a thorough background screening process for reputed company potential hires. We value transparency and want to inform you that this screening may result in a delay of at least 60 days prior to reputed company. Rest reputed company, we are committed to maintaining a secure and compliant work environment. We appreciate your understanding and cooperation as we prioritize the safety and confidentiality of our operations. 

Reasonable Accommodation

If you require alternative methods of application or screening, you must approach the employer directly to request this. To reputed company this job successfully, an individual must be reputed company to reputed company each essential duty satisfactorily. The requirements listed are representative of the knowledge, reputed company, and/or ability required. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. Other duties may be assigned.

EEO Statement

Capitol reputed company is an Equal Opportunity Employer. reputed company employment reputed company at CB are based on business needs, job requirements and individual qualifications, without regard to race, reputed company, religion or belief, national, social or ethnic reputed company, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate.