Nurse Allocator- RN Medicare Compliance

Sedgwick; Jefferson City (MO); Remote; USD 80,000 - 86,000; Full time

Job summary

A leading risk management company in Missouri is seeking a Nurse Allocator for Medicare Compliance to manage provider outreach and review documentation for Medicare Set-Aside allocations. This role offers flexibility and autonomy in a collaborative environment, prioritizing effective medical treatment for injured employees. Candidates should have an active RN license and a Bachelor’s degree in a related field. The position includes a competitive salary range of $80,000-$86,000 along with diverse benefits.

Benefits

Medical benefits

Dental benefits

401K with matching

PTO

Flexible spending account

Qualifications

• Prior medical-set-aside experience highly desired.
• Active unrestricted RN license issued in a state or territory of the United States required.

Responsibilities

• Perform provider outreach and document review.
• Prepare Medicare Set-Aside allocations.
• Analyze and interpret medical documentation.

Skills

Nursing knowledge

Rehabilitation knowledge

Communication skills

Team collaboration

Education

Bachelor's degree from an accredited college or university

Active RN license

Job description

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Nurse Allocator- RN Medicare Compliance

Prior medical-set-aside experience highly desired for this position.

PRIMARY PURPOSE OF THE ROLE

To perform provider outreach, specialized document review, and analysis and interpretation of interventions for the preparation of Medicare Set-Aside allocations.

ARE YOU AN IDEAL CANDIDATE?

We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.

• Apply your nursing or rehabilitation knowledge and experience to assist in the management of complex medical conditions, treatment planning and recovery from illness or injury.
• Work in the best of both worlds - a rewarding career making an impact on the health and lives of others, and a remote work environment.
• Enjoy flexibility and autonomy in your daily work, your location, and your career path while advocating for the most effective and efficient medical treatment for injured employees in a non-traditional setting.
• Enable our Caring counts® mission supporting injured employees from some of the world’s best brands and organizations.
• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
• Celebrate your career achievements and each other through professional development opportunities, continuing education credits, team building initiatives and more.
• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Contacts providers and attorneys to obtain clarification of documentation needed to support the preparation of Medicare Set-Aside allocations.
• Creates customized correspondence for any applicable providers that will provide the clarity needed to proceed with the preparation of the Medicare Set-Aside.
• Executes outreach activities with providers for each case via telephone, email, and fax, adhering to best practice guidelines.
• Reviews and analyzes completed documentation from providers to ensure accuracy, completeness, adherence to quality assurance standards.
• Determine the outcome of involvement to include efficacy of response, financial, and client satisfaction.
• Maintains accurate record of management including costs savings.
• Articulates and effectively documents clear and concise information.

EDUCATION AND LICENSING

Bachelor's degree from an accredited college or university preferred. Active unrestricted RN license issued in a state or territory of the United States required.

TAKING CARE OF YOU BY

• Thrives when allowed flexibility & autonomy.
• Wants dynamic company culture.
• Passionate about creativity.
• Craves culture of support, both giving and receiving.
• Thrives when everyone is working towards same vision/goals.
• Strong team and customer service orientation.
• Seeks clear role expectations.
• Wants to e valued as a collective "we".
• We offer a diverse and comprehensive benefits including medical, dental vision, 401K, PTO and more beginning your first day.

NEXT STEPS

If your application is selected to advance to the next round, recruiter will be in touch.

#nurse #medicare #medicaresetaside

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $$80,000-$86,000. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape.

For more, see sedgwick.com