Manager SIU
Location
Ohio
Posted
67 days ago
Salary
$83K - $132.8K / year
Job Description
Job Requirements
- Bachelor of Science/Arts Degree in Criminal Justice, Medical/Health Care Field or related industry or equivalent years of relevant work experience is required
- Minimum of six to eight (6-8) years of investigative or health care experience is required
- Extensive experience in health care, legal, auditing, claims and/or investigative services is required
- Leadership/supervisory experience preferred
- Solid understanding of claims processing preferred
- Knows and uphold the provisions of the Corporate Compliance Plan
- Intermediate to advanced proficiency level of computer skills, including Microsoft Outlook, Word, Excel, Access, and Power Point
- Advanced troubleshooting and problem-solving capabilities
- Significant knowledge of government program compliance requirements – Medicare, Medicaid, Affordable Care Act (ACA), etc. preferred
- Significant knowledge of medical insurance and/or state regulatory requirements.
- Certified Fraud Examiner (CFE), Certifications through America’s Health Insurance Plans (AHIP), Healthcare Anti-Fraud Association (HCAFA) and/or Managed Healthcare Professional (MHP), Accredited Health Care Fraud Investigator (AHFI), and/or Certified Professional Coder (CPC) are preferred.
Benefits
- We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
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