SIU Coordinator

Columbia MD 21046 6950 Columbia Gateway Drive

Job Description

This position is responsible for providing centralized administrative support for the Special Investigative Unit (SIU). Provides support in the referral intake process and development of leads for the SIU to assess and investigate allegations of fraud, waste or abuse. This position will perform duties to support the department’s compliance with contractual, State and Federal regulatory requirements.
  • Receive and respond to calls on the SIU Hotline and message system.
  • Retrieve supporting information and system reports and prepare referral for assignment.
  • Scan and distribute incoming mail and faxes.
  • Reviews case data to identify patterns and trends.
  • Request overpayments from providers for referrals with low exposure.
  • Prepare, send and track letters for staff.
  • Enter referrals into the case management system.
  • Handle file destruction and offsite file storage.
  • Track and process incoming checks.
  • Order office supplies.

General Job Information

Title

SIU Coordinator

Grade

18

Job Family

Finance Group

Country

United States of America

FLSA Status

United States of America (Non-Exempt)

Recruiting Start Date

9/30/2019

Date Requisition Created

9/30/2019

Work Experience

Administrative Support

Education

GED (Required), High School (Required)

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

Minimum of 5 years fraud investigations, claims processing, auditing or provider networks at expert level.- Knowledge of group health or managed care claims payment processes preferably in behavioral health.-Proven ability to effectively handle cases of fraud and abuse in a discreet, confidential, and professional manner-Demonstrated strategic and analytical thinking skills, with ability to effectively communicate conclusions and recommendations to management-Understanding of insurance terms and policy interpretation-Intermediate to high computer skills consisting of Microsoft Excel, Access, Outlook, Word and Power Point.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.

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