Medicare Set-Aside Certified Consultant RN Positions
Quadriga Group, Inc., is hiring self-motivated, experienced RNs to perform Medicare Set-Aside reviews and create reports for MedShield Settlement Solutions. MedShield Settlement Solutions is a National provider of Medicare Set-Asides for Workers’ Compensation carriers, TPAs and self-insured companies.
This position is 100% remote allowing you to set your own hours. Part Time to begin working towards Full Time. Requirements include experience with preparing Medicare Set-Asides by reviewing medical records and pharmacy reports, preparing the narrative, and determining the future medical allocations for future medical treatments and medications. Our preferred team member will possess excellent attention to detail, strong writing skills and in-depth knowledge of CMS policies and guidelines and Workers Compensation Rules.
Review of medical records and pharmacy reports to create future medical allocations related to Workers’ Compensation guidelines
- Utilize industry standard tools to identify rated ages, medical coding, treatment guidelines, and prescription medication pricing
- Analyze cost drivers and identify cost mitigation strategies on files where applicable
- RN license in good standing with the applicable Board of Nursing
- 2-4 years’ experience in the Workers’ Compensation industry preparing Medicare Set-Asides
- Certification in Medicare Set-Aside Certified Consultant (MSCC) required.
- Certified Life Care Planning (CLCP or CNLCP), Certified Case Manager (CCM) and Legal Nurse Consulting certifications are useful along with your extensive experience.
- Strong written communication skills and ability to create narratives and itemized spreadsheets via prepared templates
- Review and analyze medical information, claims payment histories/billing and pharmacy reports to identify appropriate future treatment allocations
- Work effectively both independently and as a member of a supportive team
- Must be able to meet time deadlines
- $34-45/hourly for Part Time
- $72,000-$90,000 Full Time benefits available
- Salary commensurate with experience
For further details please reach out to Dani Sequin!
Please submit cover letter, resume and redacted work samples with your application
Job Types: Full-time, Part-time
Pay: $34.00 – $45.00 per hour
- Worker’s Comensation: 2 years (Preferred)
- Michigan RN (Required)
- Medicare Set-Aside Certified Consultant (MSCC) (Required)
- CLCP, CNLCP, CCM, or Legal Nurse Consulting Certification (Preferred)