Description
With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility.
Position Overview
The Shared Services Team is seeking a new team member who thrives in a highly collaborative team oriented environment. The Compliance Analyst position requires supporting the Claims Division with all facets of Medicare and SCHIP reporting processes and assistance with general claims compliance requirements (as needed).
Responsibilities
Meet the Compliance Guidelines of CMS (Centers for Medicare Services) through knowledge of “5 Fields” for eligibility determination; as well as ICD Codes, TPOC (Total Payment to Claimant) and ORM (Ongoing Responsibility for Medial)
Maintain a close relationship with vendor partner to access reports and data in vendor dashboard and MSP Navigator and Analyzer tools.
Complete Missing Section 111 data, compare missing eligibility information to RMA
Monitor CP Link, present claims for review when necessary, forwarding and following up on Treasury Notices with Examiners.
Address any CMS alerts that arise.
Update Arch’s CMS/SCHIP Policies & Procedures Manual and Workflows as needed.
Assist Compliance team with other aspects of Claims Compliance as necessary.
Experience and Required Skills
Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word
Exceptional communication (written and verbal), influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines
Strong problem-solving, analytical, organizational, and time management skills
Advanced attention to detail ensuring work product accuracy
Applies critical thinking and produces information to identify key issues
Education
Bachelor's degree preferred
In-house and insurance/reinsurance experience; either or both preferred
1-3 years of liability and/or workers’ compensation claims handling experience required
3-5 years plus experience working preferably with insurance compliance/Medicare issues or equivalent.
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For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible.
$71,900 - $97,110/year
Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future.
Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits.
