Clinical Specialist

Description

AvonRisk is the nation’s leading specialty risk manager for self-insured organizations, uniting respected regional leaders in workers’ compensation, liability, managed care, and risk management across 32 states. With nearly 700 professionals and brands including Intercare, InterMed, George Hills, AS&G Claims Administration, Allan Koba Compliance Solutions we’re a people-focused, operations-driven organization that prioritizes reasonable caseloads, strong training, collaborative teams, and expert support.

Allan Koba Compliance Solutions is a growing Medicare Secondary Payer service provider with a national client base comprised of high-profile and globally recognized businesses. We focus on balancing our clients’ needs with Medicare Secondary Payer demands in a manner that saves time and money. Our promise is to deliver effective solutions in a prompt, clear and efficient manner. We are experiencing tremendous expansion and currently seeking a Clinical Specialist to join our team.

The ideal candidate would have 1-3 years of experience working in a professional environment. Candidates with experience in writing Medicare Set-Aside allocations and familiarity with Medicare Secondary Payer matters, workers’ compensation and/or liability insurance preferred.

Position is fully remote and can be based anywhere within the United States. Preference will be given to candidates in Eastern time zone.

Requirements

Qualifications:

Mastery of the Workers’ Compensation Medicare Set-Aside Reference Guide

Current understanding of trending with the Workers’ Compensation Review Contractor

Competence in writing Medicare Set-Asides for the purpose of CMS submission

Experience in writing Evidence Based Medicare MSAs for non-submission

Excellent writing, organizational and communication skills

Knowledge of state fee schedule pricing methodology

Familiarity with usual and customary pricing methodology

Knowledge of Redbook and alternative pharmacy pricing methodology

Ability to independently handle multiple priorities and deadlines with minimal supervision while simultaneously functioning smoothly in a fast-paced, close-knit environment

Ability to manage multiple tasks

Proficient in Microsoft Office Suite, Word and Excel

Ability to allocate pursuant to client-specific protocols and methodologies

Responsible for successful file management, problem solving and client satisfaction

Resolve and troubleshoot issues, requiring subject matter knowledge and understanding of company policies and procedures

Bachelor’s degree

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this role.

Benefits:

AvonRisk offers a competitive, people-first benefits package:

Comprehensive medical, dental, and vision benefits

Company contributions to HSA and FSA plans

Employer-paid life and disability insurance

401(k) with company match

Paid time off (PTO) and company-paid holidays

Employee assistance resources and a supportive culture that values balance and wellbeing

AvonRisk is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

Pursuant to the Los Angeles and San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest or conviction records.

Please direct inquiries with resume to [email protected]

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