Medicaid/Medicare Program Integrity Analyst I

CoventBridge Group•,

4d•$60,000 - $67,000•Remote

About The Position

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 Integrity Systems' 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.

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

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