WCMSA & Medicare Compliance Specialist

BCM Law, P.C.; United States; Hybrid; USD 90,000 - 120,000; Full time

Benefits offered by this job

Hybrid/remote flexibility

Collaborative team environment

Comprehensive benefits

Job summary

BCM Law, P.C. is seeking an experienced Medicare Set-Aside Specialist to join our growing Medicare Compliance Practice Group. This role focuses on preparing WCMSA allocations through medical record review, future cost projections, and MSP principles.

The ideal candidate will have strong Medicare Secondary Payer knowledge, experience analyzing complex medical records, and a track record of producing defensible work product in collaboration with our Medicare Compliance team nationwide.

Qualifications

• 3–5 years of WCMSA allocation experience.
• Strong knowledge of the Medicare Secondary Payer Act, CMS WCMSA Reference Guide.
• Experience reviewing complex medical records, treatment histories, and data.
• Experience projecting future medical costs for workers' compensation claims.
• Clinical background (RN, LPN, NP, PA, or other healthcare experience) preferred.
• MSCC or CMSP certification preferred.
• Strong analytical, organizational and problem-solving skills with attention to detail.
• Excellent written and verbal communication skills and the ability to work with attorneys.

Responsibilities

• Review medical records and documentation to evaluate future injury-related medical needs.
• Prepare accurate WCMSA allocations per CMS guidance and accepted methodologies.
• Project future medical and prescription costs related to work injuries.
• Evaluate case-specific facts to protect Medicare's interests during settlement.
• Prepare amended allocations and updates as circumstances evolve.
• Collaborate with the Medicare Compliance team to support settlement strategy.
• Stay current on CMS guidance and industry best practices.

Skills

Medicare compliance

WCMSA allocations

Medical record review

Communication, written

Analytical skills

Education

Healthcare background

Tools

CMSP certification

MSCC certification

Job description

BCM Law, P.C. is seeking an experienced Medicare Set-Aside Specialist to join our growing Medicare Compliance Practice Group. This role focuses on preparing WCMSA allocations through medical record review, future cost projections, and MSP principles.

The ideal candidate will have strong Medicare Secondary Payer knowledge, experience analyzing complex medical records, and a track record of producing defensible work product in collaboration with our Medicare Compliance team nationwide.