Paralegal/Medicare Account Specialist – Pittsburgh, PA

Job Title: Paralegal/Medicare Account Specialist

Location: Pittsburgh, PA

About the Job

Responsible for intake of files.  Responsible for collection, follow up, and organization of files including medical records, authorizations, set-aside submissions, and settlement documents.

Job Duties

  • Complete accurate time entry for billing purposes on a daily basis.
  • Complete authorization requests, when appropriate, at the time of file assignment and send to the appropriate individual(s).
  • Monitor and set docket activity according to the guidelines of the specific file/referral.
  • Accurately prepare Medicare Set-Asides, ensuring that the appropriate documents are submitted on a timely basis.
  • Enter and maintain data into various systems (ProLaw, Cherwell, etc.) according to departmental standards and client expectations.
  • Effectively work to obtain settlement documents, track outstanding requests, and follow up on missing documents.
  • Keep a current working knowledge of applicable CMS and MSPRC rules and regulations as they relate to Medicare Set-Asides, submissions, and conditional payments.
  • Maintain and consistently apply a thorough understanding of each client’s policies and procedures.
  • Diligently monitor various file closure trigger letters for individual files and report to the responsible attorney when matters appear to be ready for closure.
  • Review and analyze conditional payments, update information in the spreadsheet for the responsible attorney, and provide reports to client in an accurate and timely manner.
  • Serve as a knowledgeable and responsive primary point of contact for clients regarding file status, updates, items needed for referrals, submission status, etc.
  • Demonstrate a high level of professionalism and client service at all times when interacting with clients via phone, email, and in person.
  • Monitor and handle CMS development letters/requests to accurately determine needed items, provide timely reports to clients, and accurately track progress.
  • Monitor and send out CMS approval letters to clients in a timely and accurate manner.
  • Review and submit SSVS letters to clients in a timely and accurate manner.
  • Monitor revision requests from clients and promptly report to supervisor for calendar/production maintenance.
  • Use good judgment in determining when cases require escalation to the responsible attorney.
  • Use good judgment in reporting issues and potential issues to supervisor, including difficulties in obtaining information or in working with responsible attorneys.
  • Occasionally attend meetings with clients (which could include travel) to provide training or participate in client service meetings or client relations activities.

Job Requirements

  • Paralegal degree or certificate.
  • At least one year experience as a paralegal working with medical records preferred.
  • Highly organized.  Attentive to detail and highly accurate.  Patient and diligent in interacting with external agencies and internal customers.  Can understand and follow specific, detailed instructions.  Good follow through and follow up.  Strong interpersonal and communication skills (written and verbal), and ability to effectively interact with all organizational levels.  Strong computer skills, particularly MS Office.

Equipment, Physical/Mental Demands, Working Conditions

Personal computer and other office equipment such as telephone, keyboard, calculator, fax machine, duplicating machine, etc.

Sitting for extended periods, standing, bending, stooping, and reaching.  Occasional lifting up to 20 pounds.  Manual dexterity sufficient to operate standard office machines.  Range of hearing and vision sufficient to operate standard office machines and communicate extensively via telephone.

Able to deal with stress in a fast-paced work environment with multiple priorities.  Make decisions and adapt to changing work situations.  Grasp and apply new ideas and technologies.  Communicate and successfully interact with various personalities at all organizational levels.

Typical office setting, normally Monday through Friday business hours.  Occasional overtime as required.

 

Burns White conducts criminal background screenings for all newly hired employees.

No search firms
No phone calls, please
EOE


Interested candidates who meet the job requirements stated above should submit a resume and cover letter to Human Resources by email (jobs@burnswhite.com), fax (412.995.3300), or mail. No search firms. No phone calls, please.

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