MSA Solutions Analyst
Core
Prepare future medical cost projections and Medicare Set-Aside Allocation reports for workers' compensation and liability claims.
Role type
MSA Solutions Analyst
Builds
Medicare Set-Aside allocation reports and cost projections for insurance clients
Domain
Insurance / Healthcare Compliance / Workers' Compensation
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Medicare Secondary Payer statutes, jurisdictional requirements, medical terminology, regulatory guidelines, claim file analysis, medical record review, cost projection, data entry, Microsoft Office Suite
Preferred skills
Juris Doctor degree, paralegal certificate, claims management experience, MSA Analyst experience, Registered Nurse license with clinical experience
Technologies
MyConnect, Microsoft Office Suite
Responsibilities
Review and analyze medical records, claim files, hearing orders, and depositions to prepare allocation reports; Research Medicare coverage requirements and jurisdictional guidelines; Enter accurate information into MyConnect; Develop rationales for allocations and identify mitigation opportunities; Review automated pricing results for accuracy; Contact customers to clarify information and respond to compliance inquiries; Produce a minimum average of 1.2 allocation reports per day.
Seniority
Mid-level, individual contributor