Columbia MD 21046 6950 Columbia Gateway Drive
Job DescriptionThis 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
Job FamilyFinance Group
CountryUnited States of America
FLSA StatusUnited States of America (Non-Exempt)
Recruiting Start Date9/30/2019
Date Requisition Created9/30/2019
Work ExperienceAdministrative Support
EducationGED (Required), High School (Required)
License and Certifications - Required
License and Certifications - Preferred
Other Job Requirements
ResponsibilitiesMinimum 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.
Top 5 reasons to work at Magellan
Meaningful Work With People Who Care
At Magellan Health you can do meaningful work and feel confident that you matter in an organization that makes a real difference in the world - one that cares deeply and uses its employees’ collective insight as a competitive advantage.Read More
We are Compassionately Curious
Magellan Health is a place where we listen with real empathy. It’s one of our biggest strengths. It helps us to support each other and develop innovative solutions for the fastest growing, most complex areas of healthcare.Read More
We are Better Together
We rely on our innate ability to work as a high-functioning collaborative team to facilitate compassionate care to all of our members. With such interdependency comes trust, challenge and innovation.Read More
We believe work and life should flow together in unison. We offer resources that match your professional development, a culture that welcomes your ideas, and unparalleled flexibility to fit work around your life.Read More
Be your best at Magellan Health. We’re a collective of remarkably motivated and driven professionals. As a team, we’re proud of the high standards we set for each other and we’re continually inspired to do our best work.Read More
When you sayLife @ Magellan
To be the best you have to work with the bestWe hear you