Payment Integrity & Recovery Manager

For more information about the position, including the complete job description and the compensation information, click Apply Now.

• Responsible for developing, directing, and managing analytic work plans to ensure the accuracy of the data being reviewed and reported in addition to supervising a team/
• Ability to understand and interpret federal and state laws and regulations. Knowledge of Iowa-specific state regulations preferred.
• Knowledge and expertise in interpreting and applying federal compliance regulations, including HIPAA and IT security.
• Ability to develop process documentation and project quality reporting processes and procedures.
• Work with the Iowa Department of Human Services policy staff and legal counsel regarding disputed settlements.
• Assist in writing procedural updates.
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Education:
Bachelor's degree or higher, preferably in Business Administration, Public Health, Healthcare Administration, or Public Policy, or other closely related fields preferred; or equivalent experience
Experience:

• 2-5+ years of relevant work experience, including experience managing Medicaid or other healthcare payment systems and financial operations.
• Direct supervisory or management experience.

Required Skills:

• Excellent written and verbal communication, interpersonal, and client-facing skills, with an emphasis on excellent customer services.
• Ability to understand and interpret federal and state laws and regulations. Knowledge of Iowa-specific state regulations is preferred.
• Knowledge of Medicaid Third Party Liability laws and coordination of benefits.
• Knowledge and understanding of the healthcare revenue cycle with an emphasis on recovery processes.
• Ability to understand and prioritize recovery efforts to optimize recovery and recoupment.
• Strong attention to detail and ability to document and track results.
• Ability to develop reporting that captures various recovery and recoupment opportunities, including billing, denials management, and accounts receivable follow-up.
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Working Conditions:

• Hybrid Remote Schedule (1-2 days in office)
• Candidates MUST live within 2 hour driving distance to the Des Moines, IA office
• Candidates MUST be a resident of Iowa
• Travel may be required up to 10% for client meetings

Remote Work Statement:

This position is a remote, work from home position. PCG is a remote-friendly organization and is committed to creating a culture where remote work remains a vital part of the company’s success. To be successful in a remote work role at PCG, you must:

• be available during your set working hours.
• have a safe, private, and distraction-free environment in which to complete your work, and
• be able to give your full attention to the completion of your PCG job duties.

Some travel to the office or elsewhere may be required for team meetings, client meetings, etc.

We are accepting applications on an ongoing basis until filled. 

 

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Public Consulting Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, PCG employs approximately 2,000 professionals throughout the U.S.—all committed to delivering solutions that change lives for the better. The firm is a member of a family of companies with experience in all 50 states, and clients in six Canadian provinces and Europe. PCG offers clients a multidisciplinary approach to meet challenges, pursue opportunities, and serve constituents across the public sector. To learn more, visit www.publicconsultinggroup.com.

Public Consulting Group is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PCG, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PCG will not tolerate discrimination or harassment based on any of these characteristics. PCG believes in health, equality, and prosperity for everyone so we can succeed in changing the ways the public sector, including health, education, technology and human services industries, work.