Job #: 398212 Exp.: 5+ Years
The Tort Division of the New York City Law Department is seeking to fill a full-time attorney position in the Medicare Compliance & Recovery Unit (MCRU): Medicare Compliance and Recovery Officer. The person in this position would be responsible for the general supervision and maintenance of the current office-wide compliance program designed to ensure that Medicare beneficiaries who receive personal injury verdicts or settlements from the City reimburse the federal government for any Medicare conditional payments received and that any such payment is reported to the Centers for Medicaid and Medicare Services (CMS) on a quarterly basis. Working closely with the Tort Division Chief and the supervisor of the Medicare Compliance & Recovery Unit (MCRU), the Medicare Compliance and Recovery Officer will be responsible for:
monitoring all cases involving high-risk and actual Medicare beneficiaries;
maintaining the accuracy of personal identifying information (PII) in internal case management system to ensure accurate querying through the CMS interface for Section 111 reporting and MSP compliance;
handling any PII variances and appropriately note discrepancies and corrections in the internal case management system and identify instances of fraud where appropriate;
keeping track of all legislative efforts with respect to Medicare Secondary Payer Section 111 reporting and MSP compliance recovery, including all necessary websites and alerts pertaining to U.S. Center for Medicare and Medicare Services and the Medicare Secondary Payer Recovery Contractor;
maintaining statutorily required electronic records related to all efforts regarding Medicare Secondary Payer compliance, as well as recovery and reimbursement of Medicare claims;
interfacing regularly with attorneys and support professionals involved in the Medicare Secondary Payer Section 111 reporting and Medicare recovery process in the Agency, as required;
acting as liaison with the Medicare Benefits Recovery Coordination Contractor (BCRC), as necessary;
communicating with the Comptroller's Office for all Medicare-related issues;
evaluating and determining the need for, and ensuring the creation of Liability Medicare set aside allocations for anticipated future Medicare-covered medical costs on a case-by-case basis;
responding to all correspondence, motions, and discovery questions regarding Medicare Secondary Payer issues and general payment issues involving Medicare Beneficiaries;
annually reviewing closing papers to ensure the City’s rights are adequately preserved, including those pertaining to Medicare Secondary Payer and other lien issues;
promoting awareness and understanding of federal guidelines and statutes related to Medicare Secondary Payer compliance and other lien issues through individual and group training sessions related to data entry and Medicare processes;
attending webinars and CMS Town Hall Conferences and summarizing any significant changes or issues that arise involving Medicare Secondary Payer compliance and recovery issues; attending national Medicare seminars
implementing any new Medicare compliance processes as necessary in response to changes in the MSP compliance laws;
supervising and ensuring timely and accurate Section 111 reporting to Medicare of payouts involving Medicare beneficiaries, including the accuracy of ICD10 and E-coding of all Medicare Claims;
routinely quality checking the database concerning Medicare Secondary Payer compliance and related issues;
acting as liaison other Agency Divisions for all Medicare Secondary Payer issues, including Section 111 reporting; obtaining and maintaining certification as a Medicare Secondary Payer professional through a nationally recognized provider within one year after becoming the Medicare Compliance & Recovery Officer;
and generally handling all Division-wide issues regarding other lien recovery both under federal and state statutes, including, but not limited to, Medicaid, third-party liens, and attorneys' liens.
Minimum Qual Requirements Applicants must be graduates of an ABA approved law school, admitted and in good standing with the NYS bar, and have at least five years of civil litigation experience. Applicants should also have exceptional statutory and regulatory analytical skills; exceptional organizational and supervisory abilities; excellent interpersonal skills and judgment, and a strong ability to act independently. Knowledge of any particular area of law is not required, but knowledge of LawManager, Filesite, Medicare, lien law, subrogation issues, and ERISA would be a plus.
Closing Date: 18th July, 2019
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