Sorry, this job is no longer accepting applications. See below for more jobs that match what you’re looking for!

Payment Integrity Coordinator

Expired Job

Meridian Detroit , MI 48222

Posted 3 months ago


Who we are:

Meridian, a WellCare Company, is part of a national network of passionate leaders, achievers, and innovators dedicated to making a difference in the lives of our members, our providers and in the healthcare industry.

We provide government-based health plans (Medicare, Medicaid, and the Health Insurance Marketplace) in Michigan, Illinois, Indiana, and Ohio. As a part of the WellCare Family of companies, we deliver healthcare excellence to millions of members nationwide.

Our associates work hard, play hard, and give back. Meridian associates enjoy an exceptional experience and culture including special events, company sports teams, potlucks, Bagel Fridays, and volunteer opportunities.

A Day in the Life of a Payment Integrity Coordinator:

The Payment Integrity Coordinator works directly with the PI Analyst, Manager of PI, and/or the Sr. Director of Financial and Medical Analytics to coordinate the development, implementation, documentation and evaluation of all Payment Integrity initiatives. The Payment Integrity Coordinator assists, supports, and monitors all product lines. The position is responsible for supporting all payment integrity matters, including, but not limited to project facilitation and implementation, process improvement, reporting, documentation and monitoring of key performance indicators.


  • Assists with the coordination, design, and execution of activities necessary to identify trends and important aspects of care for the Meridian enrolled population

  • Conduct research, assessment and analysis for projects or reports, on an ongoing and ad hoc basis

  • Preparation of materials and documentation pertaining to all audits, reporting, and ad-hoc analyses to the Payment Integrity and Medical Cost Containment oversight committees

  • Work collaboratively within the Organization to execute strategic goals and business-related plans to facilitate efficiencies and minimize duplication across the organization

  • Facilitate and effectuate new implementations and/or process improvement through the creation, use and monitoring of work/action plans

  • Create and/or maintain department training curriculum and materials

  • Consistently demonstrate compliance with HIPAA regulations, professional conduct, and ethical practice

  • Implement new enterprise wide activities based on contractual requirements for both existing and potential contracts

  • Is able to lead and manage and ensure the timeliness of delivery of special projects as requested by the Manager of Payment Integrity

  • Performs difficult, complex, technical and/or specialized office support work, which requires the exercise of independent judgment, the application of technical skills and a detailed knowledge of the activities and procedures specific to the department

  • Provides necessary assistance with projects such as creation of spreadsheets, entering data, maintaining records related to projects and collection of necessary materials upon completion of project.

  • Provides assistance to Payment Integrity staff for creation of letter templates, organization of filing systems, mailing, faxing, copying necessary policy and procedure manuals, committee meetings, minutes, entering IT tickets, gathering specification requirements from SMEs and examples, etc.

  • Establish time frames for completion of tasks assigned

  • Prepares first draft reports on routine administrative matters

  • Review, summarize and analyze miscellaneous reports and documents; prepare background documents as necessary


What you can bring to Meridian:

  • Bachelor's degree or Fellow designation from the Academy for Healthcare Management (AHM) is preferred

  • Experience with office functions is required

  • Experience in a computerized environment is required

  • Experience coordinating mass mailings, including the use of mail merge functions, is required

  • Data entry and filing experience is required

  • Project management experience, which would include assistance in project and/or lead on specific project, is required

  • Proven experience with Word and Excel is required

  • Knowledge of various software programs including MS Word, Excel, Access

What Meridian can offer you:

  • Our healthcare benefits include a variety of plans that are effective on the first day of employment for our new full-time team members.

  • Opportunity to work with the industry's leading technologies and participate in unique projects, demonstrations, conferences, and exclusive learning opportunities.

  • Meridian offers 401k matching that is above the national average.

  • Full-time Meridian employees are eligible for tuition reimbursement towards Bachelor's or Master's degrees.

  • Meridian was named Detroit's #1 Fastest Growing Company by Crain's Magazine, so it is a great time to get involved with Meridian.

Equal Opportunity Employer

See if you are a match!

See how well your resume matches up to this job - upload your resume now.

Find your dream job anywhere
with the LiveCareer app.
Download the
LiveCareer app and find
your dream job anywhere

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Site Coordinator


Posted 7 days ago

VIEW JOBS 12/5/2018 12:00:00 AM 2019-03-05T00:00 Do you believe in the power of play to bring out the best in every kid? Would you like to work where you are encouraged to promote fun, creativity and play? If you are motivated and you possess leadership experience- both on and off the playground – we want you to join our team and put your passion for play to work for us. Playworks is the leading national nonprofit leveraging the power of play to transform children's physical and emotional health. Playworks currently serves more than 1,300 schools in 23 U.S. cities, and reaches 700,000 students directly and through professional training services. At Playworks we believe in the power of play to bring out the best in every kid. We are changing school climate by leveraging the power of safe, fun, and healthy play at school every day. We create a place for every kid on the playground to feel included, be active, and build valuable social and emotional skills. We partner with schools, districts, and after-school programs to provide a service or mix of services including on-site coaches, professional training for school staff who support recess, and consultative partnerships. Here's where you come in: In the role of Site Coordinator, you provide on-site consultation by teaming up with elementary school staff who support recess. You work directly with a designated school recess team to model and teach the strategies, games, and systems to develop and sustain a positive recess culture. In partnership with the school, Site Coordinators create opportunities where students and school staff are active, learn leadership skills and conflict resolutions tools, and practice respectful and inclusive behavior. Specifically you will have Program Implementation, Coaching, and School Partnership duties as follows- Program implementation duties * Plan and implement a consultative play-based program at four public elementary schools. * Deliver onsite coaching, consultation, and modeling to School Personnel regarding implementation of the following components: * Recess - with School Personnel create and coach recess staff to develop a safe and inclusive playground yard and be a significant presence on the yard by organizing and playing large games with 20+ students as well as role modeling positive behavior. * Student leadership program – with School Personnel organize a "Junior Coach" student leadership program by facilitating trainings as well as coaching recess staff to supervise and manage Junior Coaches during recess. * Instructional classes - lead instructional classes with elementary grade levels students and their teacher in skills building, cooperative games, and activities to increase awareness of rules, boundaries, skills utilized and cultural expectations at recess. * Maintain communication between Playworks staff, school staff, teachers, and volunteers * Collect and maintain paperwork including organizing daily, weekly, monthly schedules, meeting agendas, notes and data. * Plan and implement the learning units and recess staff trainings for program components. * Support regional team and national program department with development of programmatic learning and management resources. Coaching duties * Model Playworks core values, program implementation, group management, and rapport building strategies for School Personnel. * Provide School Personnel with action plans, goals setting, and feedback regarding program implementation. * Lead monthly meetings with School Personnel to discuss best practices for program implementation and program quality goals. * Provide Playworks Program Manager with observation notes and program strategy for program quality consultation priorities to school. * Facilitate trainings with Program Manager for school staff. School Partnership duties * Consistently represent Playworks' brand in a professional manner. * Design program schedule with input and support from school administration. * Communicate with school administration regarding program implementation logistics and management support needs. * Facilitate school's transition to other Playworks trainings, programs, and products in preparation for future school year. If you're a good fit for this position, you already know most of what this job entails. However, to be sure we're providing a complete picture, here are some details: * Success in this position will require you to be highly organized, great at multitasking, with a strong attention to detail and ability to manage time and multiple priorities * The strongest candidate will be a motivated self-starter with ability to set clear goals and follow through with flexible and creative problem solving. Required Skills & Experience * Extensive knowledge of youth development principles and practices, especially relating to social and emotional learning, play and inclusion. * At least 2 years of experience working directly with small and large groups of children. * Experience working collaboratively with adults and facilitating trainings for adults. * Strong written and oral communication and presentation skills with the ability to facilitate small and large group presentations. * Experience establishing and maintaining professional relationships with external clients and excellent interpersonal skills. * Experience interacting with diverse communities and ability to integrate into school community. * Knowledge of computer and internet based programs especially Microsoft Office (Word, Excel and PowerPoint) and GoogleDrive. * This position may require travel to various regional locations. School sites may be widely dispersed in city/region therefore daily access to reliable transportation is required. * Requires flexibility to readily adapt to a changing environment. Compensation & Benefits: Playworks offers the full package - great benefits, a fun place to work and an opportunity to grow professionally. * Competitive nonprofit salary. This is a full-time, exempt position. * A comprehensive benefits package, including medical, dental, vision, disability, 401(k) with employer match, life insurance, employee funded pre-tax health and child care spending accounts. * Generous paid time off with paid vacation, sick and holiday leave. This is a hands-on, creative, playful and fun-loving place to work, all while contributing to the success of our nation's youth. So if you're ready to immerse yourself in the education sector, working on a rewarding set of challenges and if you've got the skills, experience, passion, and a team spirit, apply! Please include: * A cover letter describing your interest in Playworks and how your experience has prepared you for this role. * Resume. * References will be requested. Service Environment: This position operates in both a school and office environment both indoors and outdoors. The position interacts with children on playgrounds and in classrooms on a daily basis. Typical physical and mental demands: This position requires sufficient physical ability and mobility to stand for extended periods at times; walk on a school site in various weather conditions; to climb stairs at some sites; to occasionally stoop, bend, kneel, crouch, reach and twist and, dependent on assignment the employee may occasionally lift, push, pull and/or move up to 50 pounds. Playworks is changing the way children experience school every day by leveraging the power of safe and healthy play. We create a place for every kid on the playground to feel included, be active, and build valuable social and emotional skills. Our ambitions demand that we invest in recruiting, developing and managing a team that reflects the broad diversity of our communities. Our core values of inclusion, respect, healthy community and healthy play are the foundation of our organization and are infused in all aspects of our work, including recruiting and retaining the best talent we can. As an equal opportunity program, Playworks encourages applications from all individuals regardless of age, gender, gender identity/expression, race, ethnicity, sexual orientation, marital status, physical ability, or any other legally protected basis. Playworks evaluates all candidates on a merit basis. Playworks Detroit MI

Payment Integrity Coordinator

Expired Job