Clinical Specialist

Job Description

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 Nurse Allocator-Clinical Specialist to join our team.

Job Summary

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.

Qualifications:

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• Mastery of the Workers’ Compensation Medicare Set-Aside Reference Guide
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• Current understanding of trending with the Workers’ Compensation Review Contractor
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• Competence in writing Medicare Set-Asides for the purpose of CMS submission
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• Experience in writing Evidence Based Medicare MSAs for non-submission
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• Excellent writing, organizational and communication skills
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• Knowledge of state fee schedule pricing methodology
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• Familiarity with usual and customary pricing methodology
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• Knowledge of Redbook and alternative pharmacy pricing methodology
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• Ability to independently handle multiple priorities and deadlines with minimal supervision while simultaneously functioning smoothly in a fast-paced, close-knit environment
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• Ability to manage multiple tasks
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• Proficient in Microsoft Office Suite, Word and Excel.
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• Ability to allocate pursuant to client-specific protocols and methodologies
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• Responsible for successful file management, problem solving and client satisfaction
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• Resolve and troubleshoot issues, requiring subject matter knowledge and understanding of company policies and procedures
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• Bachelor’s degree
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• Active nursing license
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Allan Koba Compliance Solutions offers a competitive salary commensurate with experience and excellent benefits including medical, dental, vision, life insurance and 401(K) with match. If you are seeking a career where you can achieve great things for great clients in a supportive and collaborative environment, then Allan Koba may be the place for you.

Equal Opportunity Employer

We are proud to be an Inclusive Employer. We provide an environment of mutual respect with zero tolerance to discrimination of any kind regardless of age, disability, gender identity, marital/ family status, race, religion, sex, or sexual orientation.

Our external partnerships and the dedicated work we do in promoting a transparent and fair recruitment and selection process all contribute to the successful, inclusive, and diverse culture and environment which we are proud of at Allan Koba.