MedicaidMedicare Program Integrity Analyst I
Share
Job Location:
Grove City, OH - USA
Yearly Salary:
$ 50000 - 55000
Posted on:
15 hours ago
Vacancies:
1 Vacancy
Job Summary
Overview
Medicaid/Medicare Program Integrity Analyst I - REMOTE
This position is responsible for assisting the Program Integrity Analyst II (PI2) and Program Integrity Supervisor with processing timely administrative actions.
In assuming this position you will be a critical contributor to meeting CoventBridge Groups objective: To provide services to our clients that exceed their expectations and contribute to improved healthcare delivery by identifying and eliminating fraud waste and abuse.
This position will report directly to the Program Integrity Supervisor and will work in our Grove City OH office. If not local remotely from a home office.
At this time CoventBridge is not considering candidates who require visa sponsorship currently or in the future including but not limited to H-1B H-2B E-3 TN O-1 F-1 (OPT/CPT or J-1 Visa Statuses.)
Responsibilities/ Requirements
Responsibilities:
- Enters new leads in UCM and AdvanceTrack for analysis and potential escalation to the Medicare or Medicaid teams for investigation law enforcement payment suspensions non-Lead DME national payment suspensions selection of leads for administrative action and special project leads
- Submits payment suspension activation and ad hoc requests to the MAC upon suspension approval for durable medical equipment suppliers
- Submits requests for data analysis
- Submits acknowledgment/resolution correspondence
- Updates UCM and AdvanceTrack with suspension escrow data
- Monitors revocations workload in UCM
- Compiles and maintains various documentation and other reporting requirements
- Serves as mentor and trainer to new Program Integrity staff
- Performs other projects or responsibilities as assigned by the PI Management Team
Requirements:
- Effective time management and prioritization skills
- Ability to work independently
- Ability to plan and manage multiple assignments projects and adjust to changing priorities
- Effective communication skills
- Working knowledge of AdvanceTrack and UCM or an inventory management and reporting system required
Educational/Experience Qualifications:
- High School Diploma or G.E.D equivalent
- 1-5 years related experience
Benefits
- Medical Dental Vision plans
- Life LTD and STD paid by the employer
- 401(k) with company match up to 4%
- Paid Time Off and company paid holidays
- Tuition assistance after 1 year of service
The salary range for this role is $50000 to 55000 annually. This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range and the range may be modified in the future. An employees pay position within the salary range will be based on several factors including but not limited to relevant education qualifications certifications experience skills geographic location performance and business or organizational needs.
Pursuant to the respective Fair Chance Ordinances of both Los Angeles and San Francisco we will consider for employment qualified applicants with arrest and conviction records.
About Us:
CoventBridge Group is the global leader in full-service investigations providing Surveillance SIU and Compliance Claims Investigation Counter-Fraud Programs Desktop Investigations Social Media Record Retrieval Canvasses and Vendor Management programs. The company provides top tier data privacy and security practices deploys robust case management technology customized to clients needs and delivers worldwide coverage via its 1000 employees and affiliates worldwide.
CoventBridge is an equal opportunity employer. We evaluate qualified applicants without regard to race color religion sex sexual orientation gender identity national origin caste disability veteran status and other legally protected characteristics and maintains a drug-free workplace.
CoventBridge is committed to the full inclusion of all qualified individuals. As part of this commitment CoventBridge will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process to perform essential job functions and/or to receive other benefits and privileges of employment please contact: Human Resources; ;
Required Experience:
IC
Key Skills
- Project / Program Management
- Program Management
- Data Collection
- Military Experience
- Microsoft Powerpoint
- Earned Value Management
- Sharepoint
- Microsoft Project
- Budgeting
- DoD Experience
- Financial Management
- Contracts
