biBerk Business Insurance · 4 weeks ago
Medicare Compliance Analyst - Claims
United States
Full-time
Remote
Entry, Mid Level
$70K/yr - $80K/yr
2+ years expbiBerk Business Insurance is a company that provides coverage for businesses from insurers of the Berkshire Hathaway group. They are seeking a Medicare Compliance Analyst to join their Claims Compliance team, where the primary responsibility is to ensure compliance with Medicare regulations across multiple property and casualty lines of business while managing various compliance projects.
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Responsibilities
Ensure compliance with Medicare regulations, including CMS guidelines and HIPAA privacy standards
Monitor and interpret state and federal legislation affecting Medicare claims and reporting
Maintain up-to-date documentation and reference materials related to regulatory requirements
Review and analyze Claims data for accuracy, completeness and compliance for Medicare Section 111 reporting
Identify and resolve discrepancies in claims submissions, including coding
Prepare and submit reports for regulatory filings and internal compliance tracking
Respond to inquiries from state and federal agencies regarding claims and compliance matters
Maintain detailed records of compliance activities, audits, and corrective actions related to Medicare reporting
Work closely with Claims business stakeholders, IT, legal and Compliance to ensure alignment on Medicare compliance initiatives
Support Claims BA teams in integrating compliance requirements into system updates and workflow
Stay informed on emerging regulations and industry best practices
Additional Claims compliance duties as assigned
Qualification
Required
Bachelor's degree required
Ability to assess processes to identify key areas of risk and implement resolution strategies and best practices
Ability to interact with multiple levels of staff and state regulatory authorities
Strong analytical, research, organizational, critical thinking, and project management skills and the ability to apply them in a manner that protects the company's interest while also providing the most amicable solution possible
2+ years of insurance Claims experience in all commercial lines with workers' compensation experience required
Familiarity with Medicare Secondary Payer (MSP) rules, CMS guidelines, including Section 111 reporting
Has a solid understanding of Ongoing Medicare Responsibility for Medicals (ORM) and Total Payment Obligation to claimant (TPOC) reporting requirements
Benefits
Medical (PPO/HDHP), vision, disability, and life insurance.
Enhanced dental plan with orthodontia coverage in addition to a standard plan.
Generous PTO plan for all benefit-time eligible employees.
Paid company holidays and 4 floating holidays.
Paid parental leave.
Employee Retirement Savings Plan/401(k) with company match and immediate vesting.
Education Assistance Program that offers 100% upfront tuition reimbursement after 6 months of service for approved degree programs.
Service Recognition Program that provides a monetary award to be used toward a vacation every 5 years of employment.
Wellness Initiatives that include Fitness Center and Weight Watchers Reimbursement programs.
Voluntary benefits that include accident, critical illness, and hospital indemnity.
Employee discount and rewards program on travel, tickets, electronics, home, and more.
Company
biBerk Business Insurance
biBerk helps small-business owners find the right insurance policies for their needs without extra costs and hassles.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Brian Appel MBA, CLA
Partner Services - Senior Licensed Partner Agent
Geneie Andrews
Director Of Partnerships
Recent News
biBERK Business Insurance
2025-08-18
2025-07-22
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