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 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.
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 $60,000 to $67,000 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 employee’s 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 San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
About Us:
CoventBridge Integrity Systems delivers investigative services, technology, and expertise that help healthcare and government organizations protect critical programs, strengthen oversight, and address fraud, waste, abuse, and operational risk.
CoventBridge Integrity Systems 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 Integrity Systems is committed to the full inclusion of all qualified individuals. As part of this commitment, CoventBridge Integrity Systems 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; 888-932-7364; humanresources@coventbridge.com.