Team Coord, SIU- MLTSS

Location
Virginia Beach, VA
Salary
Competitive
Posted
Feb 12, 2019
Closes
Feb 26, 2019
Ref
120941BR
Function
Management
Industry
Healthcare
Hours
Full Time
Overview:

Other
Bachelor¿s Degree in related discipline required. 5-8 years of related investigative experience. 2 + years of experience supervising investigative staff. Certified Professional Coder required (or achieved within 12 months of hire date). Accredited Healthcare Fraud Investigator (AHFI) or Certified Fraud Examiner (CFE) required. Certified Fraud Specialist (CFS), Certified Forensic Interviewer (CFI) or Certified in Healthcare Compliance (CHC) preferred.

Responsibilities:

Supervises the investigation function for an office, group or customer. Supervises the work of Investigative team including all levels of investigations, Medical Review and/or support staff. Ensures all complaints, leads and investigations are monitored, thoroughly worked and documented. Interface with regulatory agencies both state and federal. Extensive knowledge of Medicare, Medicaid program laws, regulations, resources and documentation. Creates and implements well defined work processes, establishes priorities, monitors and distributes workload. Creates and conducts investigation-related training. Foster relationships with and collaborate with business segments in organization. Supports legal proceedings as needed, including testifying in court or working with law enforcement personnel to prepare cases for civil or criminal actions. Negotiates settlement agreements to resolve disputes. Participates in special projects as required.

Qualifications:

Education Level
Bachelor's Level Degree

Experience
Required: Related - 5 years, Supervisory - 2 years

Preferred: None, unless noted in the "Other" section below

License
Required: None, unless noted in the "Other" section below

Preferred: Cert Professional Coder

Skills
Required: Complex Problem Solving, Judgment and Decision Making, Mgmt of Staff Resources, Microsoft Excel, Microsoft Word, Project Management, Quality Control Analysis, Time Management

Preferred: None, unless noted in the "Other" section below

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