Vacancy caducado!
Title: Program Integrity Analyst I
Duration: February 15, 2024 – July 15, 2024 (Position may be extended past this date)
Reports To: Program Integrity Supervisor
Job Summary
Seeking a full-time, remote, Program Integrity Analyst to assist with fraud investigations and administrative actions relating to Medicare/Medicaid claims. This position is responsible for assisting the Program Integrity Analyst II (PI2) and Program Integrity Supervisor with data entry, conducting investigative activities, and processing timely administrative actions.
Essential Duties and 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.
Compiles and maintains various documentation and other reporting requirements.
Performs other projects or responsibilities as assigned by the PI Management Team.
Competencies
To perform the job successfully, an individual should demonstrate the following competencies:
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.
Education and Experience
High School Diploma or G.E.D equivalent; preference for completed college degree, technical degree related to the position (i.e. criminal justice, statistics, data analytics. Etc.) and/or related coursework
1-5 years related experience
Preference given to individuals that have attained a Certified Fraud Examiner (CFE) designation
Salary
Commensurate with experience
Vacancy caducado!