Operations Support Center, WV25 days ago
MINIMUM QUALIFICATIONS: EDUCATION, EXPERIENCE, CERTIFICATION, AND/OR LICENSURE: Bachelor's Degree in healthcare administration, business, finance, or related field AND one (1) year of business OR healthcare-related experience OR High School Diploma or Equivalent AND Nationally Certified Pharmacy Technician (PTCB or EXPT) upon hire AND two (2) years of healthcare-related experience OR Associate's Degree AND Nationally Certified Pharmacy Technician (PTCB or EXPT) upon hire AND one (1) year of healthcare-related experience. This position is responsible for conducting payer discussions, in-house financial audits, payer performance compliance, prepayment claims audit, CMS CERT audits, CMS Fraud, Waste, & Abuse audits, and auditing 3rd party payer compliance.