Russell Raiford

Prepare Medicare Set-Aside (MSA) written reports that provided future care medical expenses related to a workers compensation injury, liability, illness or disease arising out of a work related occurrence. This was accomplished through the review of Medical records provided by the insurance company (referred to as the client). Additional products included Liability MSAs, Medical Cost Projections (MCPs), Evidence Based MSAs, Medical Zero Allocations and Legal Zero Allocations.

In addition, I provided training and mentoring for new employees, and participated in presentation of topics for company MSCC (Medicare Set-Aside Certified Consultant Program).

My primary responsibility the last few years included Quality Review Analyst/Manager QA. This position included review of written reports completed by Planners to ensure compliance with CMS Standards, as well as, client expectations.

Planner 11/26/2018 to 4/15/2019

Sedgwick CMS

Prepare Medicare Medicare Set-Aside reports that provided future care medical expenses related to injuries arising out of work-related occurrence. This was accomplished through the review of Medical records provided by the insurance company. Additional products included Medical Cost Projections (MCPs) and Evidenced Based MSAs.