Claims Administration Associate

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers.

Summary

Primary responsibility is performing the contractual and daily operational activities for the Medicare Set Aside Account and Medical Custodial Account Administration Services provided by Bridge Pointe. 

Essential Duties and Functions

• Assists with administering professional services for accounts held in fiduciary trust by Bridge Pointe.
• Ensures bills paid from the trust accounts are paid according to the terms and requirements of the fund.
• Reviews legal and financial documents for the trust accounts.
• Assists with directing the creation of invoicing for fees received and directs those deposits into the working account. Trust funds received are reviewed to ensure accuracy and compliance with contract terms prior to deposit into the individual trust accounts.
• Creates and updates Bridge Pointe letter templates for correspondence with beneficiaries, attorneys, carriers and governmental agencies.
• Ensures compliance with all governmental regulations and reporting requirements.
• Responds to communications from the CMS and MSPRC related to accounts held in trust by Bridge Pointe.
• Negotiates with potential new medical services venders for provision of  services and pricing.
• Reviews new referral intake for specifics of service or combination of services requested and ensures that new referrals are entered accurately and completely.
• Provides written quotes for Bridge Pointe services to parties involved in the settlement process.
• Evaluates and authorizes new pharmacy requests according to the terms and requirements of the fund and the contract.
• Evaluates and authorizes new supply and DME requests according to the terms and requirements of the fund and the contract.
• Ensures receipt of proper documentation to complete closure/notices/disbursement provisions for any remaining accounts funds upon account termination.
• Any other duties as may be assigned.

Qualifications/ Requirements

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.

Required Qualifications

• Minimum of a High School Diploma or equivalent
• 3 – 5 years’ experience in Workers Comp
• Exceptional telephone demeanor
• Good working knowledge of Human Anatomy
• Good working knowledge of Medical Terminology
• Proficient with MS Office Suite

Preferred

• Bachelor’s Degree or equivalent work experience
• Adjusters license
• 3-5 Years of experience in Medical Billing/Coding

We are an Equal Opportunity Employer. We take pride in the diversity of our team and seek diversity in our applicants.