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Financial Representative
Job#: 5632
Positions: 1
Posted: 06/13/2013
Job Type: Full Time
Location: Harrisburg, PA (BPI)
Department: PA Staffing
Category: Administrative
Salary: Hourly
Benefits: Full Benefits
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Job Description

Liberty Healthcare Corporation is accepting applications for a full-time Financial Representative position which will serve the Commonwealth of Pennsylvania Department of Public Welfare (DPW) Office of Medical Assistance Programs, Bureau of Program Integrity.

The mission of the Bureau of Program Integrity is to ensure that:

  • the Medical Assistance Program is protected from provider fraud, abuse, and waste;
  • medical assistance recipients receive quality medical services;
  • medical assistance recipients do not abuse their use of medical services; and
  • feedback is provided to the Department to enhance program performance.

This Bureau is comprised primarily of medical professionals responsible for preventing, detecting, deterring, and correcting fraud, abuse, and wasteful practices by providers of medical assistance services, including managed care organizations, applying administrative sanctions, and referring cases of potential fraud to the appropriate enforcement agency. This responsibility includes evaluating services rendered by medical providers and managed care organization provider networks, monitoring recipient overuse and abuse, and maintaining ongoing working relationships with federal and state enforcement agencies involved in monitoring potential health care fraud and abuse.

The Bureau of Program Integrity’s office is located at 116 East Azalea Drive in Harrisburg – in the Petry Building of the Department of General Services Annex.

Learn more about the Bureau of Program Integrity online at http://www.dpw.state.pa.us/dpworganization/officeofadministration/bpi/index.htm

The Financial Representative position provides support to the Bureau of Program Integrity’s Division of Provider Review and is responsible for the following:

  • Handle inquiries and complaints received through the Medical Assistance Provider Compliance Hotline
    • Research, compile and prepare informed reports for referrals to internal Unit Supervisors, and or other entities within DPW
  • Assist the Medical Facility Record Examiner in the Pharmacy Review Section with provider exclusion reviews by researching and compiling information from various sources including: PROMISe; LEIE; Medicheck; EPLS; Department of State; and NPPES to support the preclusion process for Criminal Convictions, DOS orders and DHHS orders.
  • Monitor the BPI-Preclusions email box and verify possible matches to the Medicheck list received from outside entities.
  • Track and record MFCS referrals from outside entities to insure payment suspension notices are in compliance with MA regulations.
  • Notify County Assistance Offices of recipient change in addresses received on returned Explanation of Benefits.
  • Type letters, memoranda, charts, reports, and other documents related to the Bureau’s program integrity functions. Proofread information for correct format, grammar and spelling, on an as needed basis.
  • Independently develop data base and/or spreadsheet applications necessary to provide information to reviewers and management staff.
  • Obtain and prepare support documents necessary for reviews, on-site visits, meetings and provider/recipient hearings.
  • Open, date stamp, and distribute incoming mail.  Prepare outgoing mail, including packages for overnight delivery to providers, recipients, attorneys or other entities.
  • Operate office equipment, i.e., personal computer, photocopy machine, and facsimile.
  • Perform data entry functions.
  • Perform receptionist duties by screening incoming calls, taking messages, greeting visitors, and receiving deliveries.
  • Schedule and coordinate meetings and/or interviews.  If required, attend meetings to take file notes.
  • Conduct filing activities by creating new files and maintaining existing files.
  • Perform any other related duties as directed by the Unit Supervisor.

This position offers:

  • Hourly compensation: $17.95 (approximately $35,000 annually)
  • Benefits including both employer and employee sponsored individual / family health insurance, dental insurance, vision insurance, long-term disability insurance
  • 25 days of paid time off annually (includes holidays, vacation, personal and sick leave)
  • 401k plan

A detailed overview of Liberty Healthcare’s benefits may be found online at http://www.libertyhealthcare.com/upload/278.pdf

Skills/Requirements

 

  • PC knowledge in Windows environment
    • Microsoft Word
    • Microsoft Outlook
    • Microsoft Excel
    • Microsoft Access
  • Data Entry Skills
  • Strong Organizational Skills
  • Ability to prioritize and manage workflow
  • Ability to meet deadlines and maintain Bureau quality standards
  • Attention to detail
  • Ability to get along well with others and work in a team environment
  • Maintains professional client relationships
  • Strong customer service skills
  • Excellent written and oral communication skills
  • Ability to quickly learn new concepts and apply them in work assignments
  • Bachelors Degree preferred but not required
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