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Medicare Set Jobs (NOW HIRING)

Capitol Bridge, LLC.

$70K/yr

Review and evaluate workers' compensation Medicare set-aside (WCMSA) proposals, including medical records, to determine if the proposal meets Medicare threshold requirements and adequately considers ...

York Risk Services

Sr. Medicare Associate

New York, NY · On-site

$20/hr

Reviews JURIS pay ledger as a guide to locate medical records needed for MCS assignment; analyzes additional records to determine if they are pertinent to Medicare Set Aside (MSA); and determines ...

Sedgwick

Sr. Medicare Associate

New York, NY · On-site

$20/hr

Reviews JURIS pay ledger as a guide to locate medical records needed for MCS assignment; analyzes additional records to determine if they are pertinent to Medicare Set Aside (MSA); and determines ...

Sedgwick

Sr. Medicare Associate

Los Angeles, CA · On-site

$20/hr

Reviews JURIS pay ledger as a guide to locate medical records needed for MCS assignment; analyzes additional records to determine if they are pertinent to Medicare Set Aside (MSA); and determines ...

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All JobsMedicare Set Jobs

Medicare Set information

See salary details

$14

$26

$47

How much do medicare set jobs pay per hour?

As of Jul 5, 2026, the average hourly pay for medicare set in the United States is $26.77, according to ZipRecruiter salary data. Most workers in this role earn between $20.19 and $28.85 per hour, depending on experience, location, and employer.

What is the difference between Medicare Set vs Medicare Claims Processor?

AspectMedicare SetMedicare Claims Processor
Required CredentialsCertification in Medicare policies, often a healthcare or insurance backgroundSimilar certifications, with focus on claims processing and insurance regulations
Work EnvironmentHealthcare facilities, insurance companies, or government agenciesInsurance companies, healthcare providers, or government offices
Employer & Industry UsageUsed in healthcare administration, insurance, and government programsPrimarily in insurance companies and healthcare organizations handling claims

Medicare Set roles focus on managing Medicare enrollment and eligibility, while Medicare Claims Processors handle the submission and processing of claims. Both roles require similar certifications and work within healthcare and insurance environments, but they serve different functions within the Medicare system.

What are the key skills and qualifications needed to thrive as a Medicare Set-Aside (MSA) Specialist, and why are they important?

To thrive as a Medicare Set-Aside (MSA) Specialist, you need a thorough understanding of Medicare regulations, workers’ compensation, and medical cost projection, often supported by a background in healthcare, case management, or legal fields. Familiarity with MSA software platforms, legal documentation systems, and certification such as Certified Medicare Set-Aside Consultant (MSCC) is highly beneficial. Strong analytical thinking, attention to detail, and effective communication are critical soft skills for coordinating with clients, attorneys, and medical providers. These skills and qualifications ensure compliance, accurate MSA allocations, and protection of Medicare’s interests in settlement cases.

What are some common challenges faced by professionals working in Medicare Set-Aside (MSA) roles?

Professionals in Medicare Set-Aside roles often encounter the challenge of staying current with frequently changing CMS guidelines and regulations. Accurately assessing future medical costs for injured individuals and ensuring compliance with federal requirements demands strong attention to detail and analytical skills. Additionally, collaborating with attorneys, claims adjusters, and medical providers can be complex, as it requires clear communication and negotiation to balance the interests of all parties while protecting Medicare's interests. Navigating these challenges successfully is essential to providing effective and compliant MSA services.

What are Medicare Set-Asides (MSAs)?

Medicare Set-Asides (MSAs) are financial arrangements used to allocate a portion of a settlement from a workers’ compensation or personal injury claim to cover future medical expenses that would otherwise be paid by Medicare. The purpose of an MSA is to ensure that Medicare does not pay for medical costs that should be covered by the settlement. MSAs are reviewed and approved by the Centers for Medicare & Medicaid Services (CMS) to ensure compliance with federal law. Properly establishing an MSA helps protect the beneficiary’s eligibility for Medicare and prevents legal complications.
More about Medicare Set jobs
What job categories do people searching Medicare Set jobs look for? The top searched job categories for Medicare Set jobs are:
Medicare Set jobs near you
Infographic showing various Medicare Set job openings in the United States as of June 2026, with employment types broken down into 73% Full Time, 20% Part Time, and 7% Temporary. Highlights an 100% In-person job distribution, with an average salary of $55,676 per year, or $26.8 per hour.
WCRC Attorney (58516)

WCRC Attorney (58516)

Capitol Bridge, LLC.

On-site

$70K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 18 days ago

Job description

About Capitol Bridge

Founded in 2012, Capitol Bridge is based in Arlington, Virginia and has proven expertise providing independent medical reviews, records/data management services, medical coding, administrative staffing and eligibility reviews.

Capitol Bridge LLC is seeking an WCRC Attorney to support an important government project. In this role you will, in accordance with CMS guidelines, evaluate Workers’ Compensation Medicare Set-aside Arrangement (WCMSA) proposals and project the future medical costs, including prescription drugs, related to the workers’ compensation (WC) injury, illness, or disease that would be otherwise reimbursable by Medicare.

Job Description:

Review and evaluate workers’ compensation Medicare set-aside (WCMSA) proposals, including medical records, to determine if the proposal meets Medicare threshold requirements and adequately considers Medicare’s interests as pertaining to future medical needs ofbeneficiaries.Ensure all basic documentation requirements are available or requested via development action prior tomaking adetermination.Render determinations based on professional experience.Implement Medicarepolicy.Other duties as assigned bymanagement.

Qualifications:

  • Juris Doctor (JD) from an accredited law school,required.

  • Medicalrecordreview experience,required.

  • Medicare Set-Aside (MSA) or related experience, preferred

  • Possess medical knowledge and experience with medical terminology, ICD-9/10 Codes, Current Procedure Terminology Codes (CPT)codes, Healthcare Common Procedure Coding System (HCPCS) codes, and hospital inpatient and outpatient coding, preferred.

  • Medicare Set-Aside Certified Consultant (MSCC) certification and/or Certified Medicare Secondary Payer (CMSP) certification,preferred.

Pay and Benefits:

  • Base Rate starting at $70,000

  • Medical, Dental, and Vision benefits available

  • 401(k) available with company match

  • Paid holidays

  • Unlimited PTO

Screenings Required:

You will receive requests for background check, fair credit check, and drug screen regarding this employment opportunity. Respond to all requests quickly as we anticipate filling our vacancies quickly and non-responses may result in disqualification for this opportunity.

*Please be aware that our organization and our client adhere to stringent security regulations, necessitating a thorough background screening process for all potential hires. We value transparency and want to inform you that this screening may result in a delay of at least 60 days prior to onboarding. Rest assured, we are committed to maintaining a secure and compliant work environment. We appreciate your understanding and cooperation as we prioritize the safety and confidentiality of our operations.

Reasonable Accommodation:

If you require alternative methods of application or screening, you must approach the employer directly to request this. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned.

EEO Statement:

Capitol Bridge is an Equal Opportunity Employer. All employment decisions at CB are based on business needs, job requirements and individual qualifications, without regard to race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate.

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