Policy Specialist
Core
Provide technical expertise and guidance to ensure compliance with CMS statutes, regulations, and policies regarding Coordination of Benefits and Medicare Secondary Payer recovery.
Role type
Senior IC policy specialist (Medicare/MSP)
Builds
Operational compliance for CMS Benefits Coordination and Recovery Center contract
Domain
Healthcare administration / Federal government contracting
Deliverable
client delivery
Required skills
CMS Coordination of Benefits (COB) policy interpretation, Medicare Secondary Payer (MSP) recovery expertise, CMS Internet-Only Manual (IOM) guidelines, HIPAA compliance, MSP systems operation (ReMAS, CWF/HIMR, ECRS, HIGLAS, BCRS), procedural documentation, regulatory analysis
Preferred skills
None stated
Technologies
ReMAS, CWF/HIMR, ECRS, HIGLAS, BCRS, Microsoft Office Suite
Responsibilities
Review and implement policy guidelines for COB and MSP recovery, provide feedback on Standard Operating Procedure changes, collaborate with cross-functional teams to ensure regulatory adherence, work with CMS on policy issues and technical direction, identify trends and recommend process improvements
Seniority
Senior, hands-on IC
