Responsible for providing oversight to the frontline staff including technical direction, guidance & resources for frontline staff on discovery, validation, recovery, and adjustments of claims overpayment processes on a day-to-day basis. Primary duties may include, but are not limited to: Serves as a first line resource for frontline staff on workflow and technical related processes. Collaborates with other areas to ensure high quality customer satisfaction. May work with external vendors and internal data mining to validate overpayments, validate vendor invoices, and provide feedback to modify queries. Partners with management to identify and correct contractual issues. Provides assistance to associates on answering day-to-day technical questions; reviews department policy and procedure manuals for accuracy; works with training department to ensure procedures and policies are accurate and complete. Participates in projects to identify process improvements and prevent overpayments. Trains new associates and provides on-going training to Financial Ops Processors /Recovery Specialists. Performs audits to monitor efficiency and compliance with policies. Managers team workflow and supports management on a daily basis, including maintaining of inventory reports. Hires, trains, coaches, counsels, and evaluates performance of direct reports. Requires a BA/BS degree; 2 years of management experience; or any combination of education and experience, which would provide an equivalent background.
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