Managed Care Advisors

  • Lead Claims Specialist

    Job Locations US-MD-Bethesda
    Posted Date 4 months ago(5/2/2018 3:58 PM)
    Job ID
    2018-1059
    Category
    Customer Service/Support
  • Overview

    Managed Care Advisors (MCA), a rapidly expanding Consulting and Full-Service Claims and Medical Case Management Company, has an immediate opening for a self-motivated, detail oriented Lead Claims Specialist to service federal government customers nationwide and across all US Territories.  Live locally in the District, Maryland or Virginia and work at our Bethesda office located within walking distance to the Metro.

     

    Come join our winning team and grow with us!

     

    Managed Care Advisors

    • Provides an exciting and fast paced work environment
    • Provides growth opportunities and cultivates talent
    • Celebrates our individual and team successes together
    • Provides a comprehensive benefits package
    • Supports a team oriented work atmosphere

    Responsibilities

    MCA’s Lead Claims Specialist provides guidance to the Claims Team and communicates with all workers’ compensation stakeholders, including the Agency and the Office of Workers’ Compensation Programs (OWCP) /U.S. Department Labor.  Lead Claims Specialists serve as a resource to Agency partners in complex cases, and provide training to MCA Claims Specialists and other staff. Other responsibilities include:

     

     

    • Educating and assisting federal employees with claims under the Federal Employees’ Compensation Act (FECA).
    • Using the Employees’ Compensation Operations and Management Portal (ECOMP) to monitor, review, and submit claims for workers’ compensation benefits.
    • Facilitating the timely completion and submission of all required forms.
    • Confirming facts surrounding the incident, as reported.
    • Reviewing medical and administrative documentation for accuracy.
    • Identifying and resolving claims documentation omissions or deficiencies.
    • Answering questions with regard to the claims process.
    • Developing Continuation of Pay authorization and denial memos.
    • Supervising Claims Specialists in day-to-day claims operations.
    • Performing quality assurance audits and monitoring unit performance.
    • Maintaining staffing for call center in accordance with contract requirements.

    Qualifications

    • Bachelor’s degree
    • A minimum of 4 years’ experience in workers’ compensation, lost time claim handling, claims adjuster/administration, case management, claims life cycle, and/or utilization review
    • One to two years supervisory experience preferred
    • Federal Employees' Compensation Act (FECA) knowledge preferred
    • Experience working with the Department of Labor preferred
    • Active federal security clearance preferred
    • United States citizenship
    • Strong computer skills (Microsoft Excel, Word, PowerPoint, and Outlook)
    • Ability to work independently and make decisions
    • Attention to detail
    • Excellent verbal, written, and interpersonal communications skills
    • Upon hire, successful candidate will be required to obtain a confidential-level security clearance

          To be considered for this position, please submit a cover letter and resume, and complete the application.

     

    The information provided above has been designed to indicate the general nature and level of work of the position. It is not a comprehensive inventory of all duties, responsibilities and qualifications required.

     

     Important Information

     

    Successful candidates will be required to undergo a credit and criminal background check, and obtain and maintain confidential-level security clearance upon hire. We participate in the United States Federal Government E-Verify program to confirm the employment authorization of employee upon hire.

     

    MCA strives to make our career site accessible to all users. If you need a disability-related accommodation for completing the application process, please contact MCA regarding accommodations. 

     

    MCA is an Equal Opportunity and Affirmative Action Employer

     

    All qualified applicants will receive consideration for employment without regard to age, citizenship status, color, disability, marital status, national origin, race, religion, sex, sexual orientation, gender identity, veteran status or any other classification protected by federal state or local laws as appropriate, or upon the protected status of the person’s relatives, friends or associates.

     

    MCA abides by the requirements of 41 CFR 60-741.5(a). This regulation prohibits discrimination against qualified individuals on the basis of disability, and requires affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified individuals with disabilities.

    MCA abides by the requirements of 41 CFR 60-300.5(a). This regulation prohibits discrimination against qualified protected veterans, and requires affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified protected veterans.

     

     

     

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