Note: The job is a remote job and is open to candidates in USA. BCM Law, P.C. is seeking an experienced Medicare Compliance Consultant to join their collaborative and growing Medicare Compliance Practice Group. The role involves providing strategic analysis, preparing and reviewing Medicare Set-Asides, and navigating the CMS submission and approval process in support of complex workers’ compensation matters.
Responsibilities
- Evaluate case-specific facts to determine appropriate methods of considering and protecting Medicare’s interests
- Prepare and review Medicare Set-Aside allocations, future medical cost projections, and non-Medicare-covered cost analyses
- Submit and manage MSAs through the CMS Workers’ Compensation Set-Aside Web Portal and respond to development letters
- Investigate and assist with Medicare conditional payment and Medicare Advantage resolution
- Monitor CMS guideline updates and approval trends to ensure defensible and compliant submissions
- Collaborate closely with the firm’s Medicare attorney and litigation teams to support settlement strategy
- Participate in MSP industry education and professional organizations (e.g., MSPN)
- Support client education efforts related to Medicare compliance considerations
Skills
- Minimum 3–5 years of experience in Medicare Secondary Payer compliance, Medicare Set-Aside preparation, and CMS submission coordination
- Strong working knowledge of the Medicare Secondary Payer Act and CMS guidelines
- Direct experience with the CMS Workers' Compensation Set-Aside Web Portal, submission process, and development letter responses
- Experience reviewing and analyzing medical records, treatment histories, and payment data to project future medical exposure
- Experience communicating with Medicare and Medicare Advantage contractors to resolve conditional payment issues
- Excellent oral and written communication skills
- Strong organizational skills, attention to detail, and ability to manage a high-volume caseload independently
- Strong analytical and interpretive skills
- Professional, reliable, and comfortable working directly with attorneys, adjusters, and clients
- MSCC and CMSP designation strongly preferred
Benefits
- Competitive compensation and comprehensive benefits
- Hybrid/remote flexibility with a collaborative and supportive team environment
- Meaningful, hands-on work supporting complex cases nationwide
- Opportunities to continue developing expertise in Medicare compliance and industry best practices
- Consistent communication, feedback, and leadership support
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