Audit & Recovery Manager
Job Id: 593
Contact: Tina Jennings
Salary: 55k Euros
Contract Term: Permanent
Contract Type: Full Time
Expires: 18 June 2016
Location:
The Manager of Network Audit & Recovery is responsible for performing comprehensive research and identifying billing abnormalities, questionable billing practices, and/or irregularities. Managers of Network Audit & Recovery will investigate, research, and analyze claims data, applying knowledge of medical or pharmacy policy to determine details of fraudulent or abusive billing activity.
Core competencies for this role include:
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Leads and operates in a progressive People management environment
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Operates in a highly regulated quality driven organization
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Operations excellence through daily operations management (Key Metric Indicators / Management By Objectives)
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Operating in a matrix environment with multiple stakeholders
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Reporting on performance against targets – daily/weekly/monthly
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Developing recovering plans for gaps to target
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Leads on implementing continuous improvements through recovery plans as required or strategic improvements
Primary Responsibilities:
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The position will manage new and existing staff (hiring, training, and mentoring)
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The manager's team will review medicare paid claims and identify system and procedural discrepancies/errors
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Manager is responsible for meeting/maintaining department metrics and quality standards
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Manager is also responsible for ensuring team meets customer expectations
Required Qualifications and Experience:
- Bachelor's Degree in related areas and or experience in Healthcare insurance/financial services industry (or equivalent work experience)
- 3-5+ years’ experience in a financial service industry, preferably in claims and/or audit/recovery role.
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5+ years of experience Reporting on performance against targets – daily/weekly/monthly: analyzing key performance indicator trends for all operational areas including P&L
- 5+ years of experience in Operations excellence through daily operations management (Key Metric Indicators / Management By Objectives) : establishing operational scorecards and appropriate business targets, budgets and forecasting based on analysis. Developing recovering plans for gaps to target
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3-5+ years of experience in Leading and operating in a progressive People management environment and/or Operating in a matrix environment with multiple stakeholders
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5+ years of experience Operating in a highly regulated quality driven organization
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3+ years of experience Leads on implementing continuous improvements through recovery plans as required or strategic improvements
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Advanced Microsoft Office skills with Excel, PowerPoint
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