Medicare Compliance Analyst (Hybrid) at Chubb in Wilmington, Delaware

Job Description:

Medicare Compliance Analyst  

 

SCOPE

 

Chubb North America Claims seeks a Medicare Compliance Analyst to serve as part of Chubb’s Medicare Claims Compliance group.  The position offers an opportunity to gain a keen understanding and working knowledge of the laws and regulations surrounding Medicare.  The position will further expose the candidate to a wide variety of state and federal laws impacted by Medicare, including state and federal workers’ compensation programs, property and casualty insurance products, and accident and health programs.  The position will allow broad opportunities for growth within Chubb and expose the candidate to numerous internal and external stakeholders, including Chubb NA Claims, its Discipline Leadership, Executive Management, Legal & Compliance, outside counsel, representatives of the U.S Government and state authorities, insureds, brokers, agents, and Third-Party Claims Administrators (“TPAs”).     

RESPONSIBILITIES

1.       Data Analysis and Reporting:  Evaluate and collate data with respect to Medicare reporting based upon lines of business and issue presented.  (TPA Oversight, Direct Handled, Specialized Lines). 

2.       Manage Beneficiary Look-up and Section 111 Reporting:  Review and distribute monthly error reports. Work  with others in Medicare Compliance to identify and correct root causes for the errors,  and develop corrective action plans.  Communicate and work alongside Medicare vendor and business units to correct errors and ensure ongoing improvements and trends.  Conduct off-cycle beneficiary lookups as needed.

3.       Management of Vendor Exception Requests: Review, document and prepare responses to Insureds’ requests to employ a vendor other than Chubb’s preferred vendor. Assist in oversight of work performed by these vendors to ensure compliance with Medicare’s requirements and Chubb’s guidelines.

4.       Development Of Medicare Programs:  Assist in the development, communications, and training of Chubb NA Claims Medicare Compliance Programs in concert with our Medicare vendor and other Medicare Claims Compliance personnel.  Manage Chubb’s Medicare Compliance page within Chubb’s Intranet site.

5.       Conditional Payment/Medicare Lien Research and Analysis:  Research and address Conditional Payment obligations and MAP/PDP liens both with respect to direct handle claims and TPA lines of business and assist in the development of root cause analysis and corrective action plans.  Monitor, evaluate, and manage open debt reports through resolution.  Manage treasury notice from claim file research through resolution. Investigate US Department of Treasury offsets and work with Chubb’s Medicare vendor, TPAs and Chubb Claims to bring to resolution. 

6.       Track Developments in Medicare:  Monitor and track changes to CMS requirements, and work with internal and external stakeholders, as well as Medicare vendor, to identify and propose changes to internal and TPA policies, procedures, best practices, and workflows.  Disseminate information as requested. 

7.       Audit Inquires: Review and prepare responses to CMS Audits.

8.       Vendor Management: Assist in the oversight of Chubb’s Medicare vendor, respond to inquires and ensure payment of vendor invoices.

9.       Medicare Administration:  Provide general oversight and assistance to Chubb’s Medicare process, including RRE ID management, management of annual renewals, compliance alerts to employers, TPAs, brokers and Chubb staff, and other projects identified.   

QUALIFICATIONS

 

§  Strong analytical and technical skills required.  Agile use of Microsoft Office Suite required.

§  Ability to prioritize and work in a fast-pace and dynamic environment, managing multiple tasks and projects simultaneously.

§  Excellent communications skills, both oral and written.  Strong  interpersonal skills.

§  Able to work independently, as well as in groups.

·      Project management experience a plus.

 

EDUCATIONAL AND PROFESSIONAL REQUIREMENTS

 Candidates pursuing an education in a university or community college setting focused on a later degree or designation in risk management, insurance, business, or law desired.   

Chubb offers a competitive compensation package and comprehensive benefits package including life, health and dental, vision, a generous retirement savings plan, disability coverage, stock purchase plan, flexible spending accounts, tuition reimbursement, and business casual dress. At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religion, age, sex, sexual orientation, transgender, national origin, disability, genetic information, veteran or marital status, or any other characteristic protected by law.                                

For additional information about Chubb or its services, please visit our website at www.chubb.com/careers

In order to be considered an applicant for employment with Chubb, all applicants must go to Chubb’s Careers website to apply for the position(s) of interest and complete an online application. If you do not complete the online application, you will not be considered an applicant in accordance with Chubb’s policy.

 

The pay range for the role is $47,500 to $75,500. The specific offer will depend on an applicant’s skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program.  Chubb offers a comprehensive benefits package, more details on which can be found at https://careers.chubb.com/global/en/north-america.  The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled.  

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