MEDICAL AUDITOR II (PROGRAM INTEGRITY AUDITOR II) in Chicago, IL

MEDICAL AUDITOR II (PROGRAM INTEGRITY AUDITOR II) - State of Illinois - Chicago, IL - work from home jobCompany: State of IllinoisJob description: Agency : Department of Healthcare and Family ServicesJob Posting ID: IG30450BPIS: 07992Group: AStart Date: 08/23/2023Closing Date: 09/06/2023Salary: $5,246 - $7,827 (ANTICIPATED SALARY FOR NON-STATE $5,246)Job Type: Salaried Full TimeCounty: CookNumber of Vacancies: 1Plan/BU: RC062This position is a union position; therefore, provisions of the relevant collective bargaining agreement/labor contract apply to the filling of this position.All applicants who want to be considered for this position MUST apply electronically through the website. State of Illinois employees should click the link near the top left to apply through the employee career portal. If you are seeking a Transfer: Please remember to upload a State of Illinois Department of Central Management Services American Federation of State, County, and Municipal Employees (AFSCME) - Transfer Request Form. State of Illinois employees should click the link near the top left to apply through the employee career portal.Applications submitted via email or any paper manner (mail, fax, hand delivery) will not be considered. Posting Identification Number IG30450Job Posting Details:The Office of Inspector General for the Department of Healthcare and Family Services is seeking a highly capable and experienced professional to serve as a Medical Coder II. The ideal candidate for this challenging and rewarding role will productively learn auditing medical records. They will understand Medicaid and managed care and the state and federal regulatory landscape for healthcare providers.The ideal candidate will demonstrate the ability to exercise sound judgment in the identification of priorities, to work collaboratively with internal and external partners, to proactively address issues, and to ensure timely completion of all work. The ideal candidate will exhibit strong audit medical skills to achieve set goals while demonstrating independent initiative and possess strong written and verbal communication skills. HFS values employees with different backgrounds, life experiences, and talents.Employees receive a robust benefit package including:• Monday-Friday work schedule• Flexible work schedules are available in many program areas. (Remote work may be an option for certain positions.)• Health, Life, Vision, and Dental Insurance• Pension Plan• (10) Weeks paid Maternity/Paternity Leave• DeferredCompensation Program and other pre-tax benefit programs (Medical/Daycare)• Employees earn (12) paid Sick Days annually• New Employees earn (10) paid Vacation Days their first year of service and can earn up to (25) paid Vacation Days annually• Employees earn (3) paid Personal Days annually• (13-14) paid holidays annually (based on start date)If you are seeking a new opportunity, and this position appeals to you, please !At the Illinois Department of Healthcare and Family Services (HFS), we value staff as our greatest asset. We work in a spirit of teamwork to help millions of Illinoisans access high quality healthcare and fulfill child support obligations to advance their physical, mental, and financial well-being. We provide healthcare coverage for children and adults through Medicaid and other medical programs, and we help ensure that children receive financial resources from both their parents through Child Support Services.The HFS Office of the Inspector General investigates, audits and reviews program activity to ensure the integrity of our programs is maintained. HFS is committed to promoting and preserving a workplace culture that embraces diversity, equity, and inclusion. We welcome and value employees with different backgrounds, life experiences, and talents. It is the collective sum of our individual differences that provides a broad perspective, leading to greater innovation and achievement. In recruiting for our team, we recognize the unique contributions of each applicant regardless of culture, ethnicity, race, national origin, sex, gender identity and expression, age, religion, disability, and sexual orientation.HFS is an equal opportunity employer. Job Responsibilities• Serves as a Medical Auditor II and independently conducts on-site audits of providers participating in the Medical Assistance Program• Writes comprehensive audit reports, audit results, calculations, and audit schedules utilizing applications such as Word and Excel• Monitors work for quality control• Contacts providers to be audited• Reviews audit scope with immediate supervisor• Conducts exit interview with representative/provider• Testifies on behalf of the Department at administrative hearings and reviews as an expert accounting witness regarding audit findings that result in the termination or suspension of providers from the Medical Assistance Program, or the recovery of overpayments made to such providers• Serves as liaison between the Department and the provider• Performs other duties as required or assigned which are reasonably within the scope of the duties enumerated aboveMinimum Qualifications• ​​​​Requires knowledge, skill and mental development equivalent to a bachelor’s degree, preferably with major coursework in accounting or business administration• Requires one year of experience such as could be acquired as a Program Integrity Auditor I and satisfactory completion of an agency-sponsored program integrity training programPreferred Qualifications• Two (2) years of experience as a certified medical coder• Certification as a medical coder from a national organization such as American Academy ofProfessional Coders (AAPC) or American Health Information Management Association (AHIMA)• Extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to medical documentation, coding, and billing• Two (2) years of professional experience conducting audits for an organization• Two (2) years of experience utilizing medical terminology, physiology, and anatomy• Two (2) years of experience working with internal and external stakeholders• Basic proficiency with Microsoft Word and Excel or other similar softwareConditions of Employment• Requires the ability to pass a background check• Requires a valid Illinois driver’s license• Requires the ability to travel to various sites throughout the State to assist in conducting audits• The conditions of employment listed here are incorporated and related to any of the job duties as listed in the job descriptionWork Hours: 8:30 a.m.- 5:00 p.m. Monday - FridayWork Location: 401 S Clinton St Chicago, IL 60607-3800Agency Contact: [email protected] Family: Legal, Audit & ComplianceThis position DOES NOT contain “Specialized Skills” (as that term is used in CBAs). APPLICATION INSTRUCTIONSUse the “Apply” button at the top right or bottom right of this posting to begin the application process. If you are not already signed in, you will be prompted to do so. State employees should sign in to the career portal for State of Illinois employees – a link is available at the top left of the homepage in the blue ribbon.Non-State employees should log in on the using the “View Profile” link in the top right of the homepage in the blue ribbon. If you have never before signed in, you will be prompted to create an account. If you have questions about, please see the following resources:State employees: Log in to the for State employees and review theNon-State employees: on – click “Application Procedures” in the footer of every page of the website. The main form of communication will be through email. Please check your “junk mail”, “spam”, or “other” folder for communication(s) regarding any submitted application(s).You may receive emails from the following addresses:• [email protected]• [email protected] salary: $5246 - 7827 per monthLocation: Chicago, ILJob date: Wed, 23 Aug 2023 22:28:29 GMTApply for the job now! Apply tot his job