Medicaid/Medicare Program Integrity Analyst I
About The Position
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 Group's 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.)
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
- High School Diploma or G.E.D equivalent
- 1-5 years related experience
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
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
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
