Validation Specialist

Charles Lea CenterClarksville, TN
$27Onsite

About The Position

The Validation Specialist will be responsible for ensuring the completion, timeliness, and accuracy of value-based payment authorization for the statewide ICS program. The Validation Specialist maintains accurate evidence, review documentation, and implements milestone validation review procedures that justify the approved or denied billing validations. Will also be responsible for providing strategic technical assistance to provider agencies to obtain required evidence based on the MAPs programs service definitions provided by the Department of Disability and Aging (DDA) program requirements. Support with leading innovative approaches to streamline the internal ICS milestone validation review process for efficiency and increased productivity.

Requirements

  • At least 18 years of age
  • Must be able to effectively read, write, and communicate verbally in English
  • Ability to pass a background check upon hire
  • Valid TN driver's license
  • Vehicle Insurance
  • Bachelor’s degree from an accredited college or university in bookkeeping, accounting, business administration or another relevant field.
  • Bachelor’s degree from an accredited college or university in a non-related field, plus one year of experience in bookkeeping, accounting, business administration, or relevant field.
  • Associate’s degree, a High School Diploma, or a GED, combined with two years of university experience in bookkeeping, accounting, business administration, or relevant field.

Nice To Haves

  • Some knowledge of current technologies and products used in the industry is preferred.
  • Experience with value-based payment models is a plus.
  • Experience working with the Department of Disability and Aging is a plus.

Responsibilities

  • Works closely with the MAPs Network to review milestone validation submissions; auditing submissions for accuracy with provided evidence to support authorization for payment approvals.
  • Apply strong communication and customer services skills, while effectively working with various service areas to authorize value-based payment authorizations to provider agencies.
  • Complete Person-Centered training to model throughout the work being performed.
  • Review completed annual Person Supported Centered Plans (PSCP’s) to determine validation accuracy and compliance.
  • Provide detailed technical assistance and support to provider agencies based on errors, required evidence needed, while communicating denial and or approval updates when processing milestone validations.
  • Complete all milestone validation review process within the required timeframes.
  • Follow all DDA and CLC policies and protocols regarding compliance, and ethical billing practices.
  • Assess milestone validation process trends for efficiencies and opportunities, while providing monthly reporting on approval rate.
  • Other duties as assigned.

Benefits

  • medical
  • dental
  • vision
  • life insurance
  • a 401(k)
  • paid time off (PTO)
  • tuition reimbursement
  • access to online wellness clinic
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