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Payment Integrity Coordinator

Expired Job

Meridian Detroit , MI 48222

Posted 3 months ago

Overview

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.

Responsibilities

  • 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

Qualifications

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


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Payment Integrity Coordinator

Expired Job

Meridian