Under the direction of the Medicare Compliance Director serves as a Sr SCHIP Account Manager for Broadspire. Attends new client takeover meetings and ensures that MMSEA Section 111 Mandatory Insurance Reporting federal requirements are met for clients and carriers. Works directly with clients and Client Services coordinating all efforts related to CMS matters. Ensures that quality data, products, and services are delivered in support of SCHIP compliance

• Attends new client implementation meetings, advises clients on the SCHIP Section 111 Reporting requirements and assists them with RRE registration with CMS. Escalates to Client Services when clients fail to register or recertify their annual Profile Report with CMS.
• Monitors client reporting with CMS and addresses reporting errors for each RRE when there are CMS file failures and resubmits their file for reporting.
• Performs client program setup in the SCHIP table, entering clear basic rules, performs testing to ensure the correct program and claims are extracted. Monitors the new files to ensure reporting is successful.
• Participates in testing when programming changes are made within RMA, or any of the SSRS reports, SCHIP Webui and external vendor system used by Broadspire.
• Supports other SCHIP reporting responsibilities including running SSRS reports as required.
• Participates in the development of training materials and jointly provides training with Medicare Compliance Director and claim adjusters.
• Creates departmental and escalation SOP’s for all aspects of the SCHIP Compliance Team.

• Bachelor’s degree in Business, Business Administration, Insurance or the equivalent combination of education and experience.
• 5 years or more of experience working within the Medicare Secondary Payer space including Section 111 Mandatory Insurance Reporting
• 5 years or more experience with client interfacing.
• Experience using business analytical skills to perform testing and writing rules and setup of SCHIP technical reporting.
• Proficient with excel and word and power point.
• Experience developing SOP’s.
• Demonstrates a sound knowledge of basic business principles.
• Demonstrates the ability to plan projects and complete assignments timely and accurately.
• Demonstrates an aptitude for creating basic logic and rules within the proprietary SCHIP database to setup client programs to extract the appropriate claim data.
• Understands the impact of decisions, actions, and technology on Broadspire’s and customers business systems.
• Excellent understanding of process and systems flow.
• Displays excellent interpersonal skills.
• Displays excellent presentation and training skills.
• Displays ownership in business relationships and assignments.
• Ability to clearly present information through the spoken or written word; reads and interprets complex information; talk with customers or clients; listens well.
• Ability to stay well informed of current industry trends; learn and apply new concepts and identifies own areas of opportunity and sets and monitors self-development goals.
• Ability to demonstrate a high level of service delivery; do what is necessary to ensure customer satisfaction; deals with service failures and prioritizes customer needs.
• Ability to challenge conventional practices; adapt established methods for new uses; pursues ongoing system improvement; develops new ideas to create novel solutions to problems; evaluates new technology as potential solutions to existing problems.
• Demonstrates or models behavior that rallies others around a common cause and builds a shared sense of purpose.
• Ability to develop rapport with others and recognize their concerns and feelings; builds and maintains long-term associations based on trust; helps others.
• Solid experience and decision-making escalating issues that require the intervention from CMS or Client Services.
• Understands the importance of timely escalation to resolve critical issues.
• Must complete continuing education requirements as outlined by Crawford Educational Services

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