Data Processing Reviewer – PT
Department – PERM
Company – A+ Government Solutions

Opening Date: 11/22/11
Closing Date: 1/31/2012
Salary: $23.00/hr + potential overtime with reimbursement of expenses
Location: Home-based with travel required

Summary Statement:
A+ Government Solutions is seeking well-qualified individuals to review claims for the Payment Error Rate Measurement (PERM) project. The PERM project produces annual error rates for Medicaid and CHIP programs. The open positions are PT and require a minimum of one week travel per month. Some remote work is also available to supplement reviews done during travel weeks.

Position Responsibilities:

a. Conduct reviews of paid claims in a state Medicaid system on-site at Medicaid agencies in various states, or remotely (when assigned) on a telecommuting basis
b. Determine accuracy of payment and processing of claims
c. Document information from each review into a database or Excel spreadsheet
d. Work as part of a team to identify and report error trends in each state
e. Maintain the confidentiality of all records during the audit process
f. Identify and report potential fraud discovered during the audit process.

Desired Qualifications:
Education/Experience:

a. Require a minimum of High School Diploma
b. Desired - an Associate's or Bachelor's Degree
c. Minimum of 5 years experience with a Medicaid agency desired
d. Knowledge of Medicaid programs and Medicaid Management Information Systems (MMIS)
e. Experience working as an auditor, Quality Control/Assurance reviewer, or with Medicaid or other health insurance claims is preferred
f. Candidates must be available to travel out of state an average of 1 (one) full week per month to conduct reviews on-site.

Required Skills:

a. Detail-oriented
b. Technical expertise
c. Exceptional investigative and analytical skills
d. Strong communication and organizational skills
e. Self-directed individual and a team player
f. Proficient in Microsoft Word and Excel programs
g. Excellent writing and reporting skills

Send Applications to: info@aplusgov.com

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