Under the direction of the Associate Director of Internal Audit or above, the Cost Avoidance
Manager is responsible for building, leading, and managing the HealthPlan’s Cost Avoidance and
Recovery Teams. The purpose of the Cost Avoidance Team is to monitor payment of claims. The
purpose of the Recovery Team is to identify overpayments for recovery; research and post
provider refund checks, monitor receivables in the Core System; identify, verify, and update Core
System with members’ other health insurance coverage information as required.
Secondary Duties and Responsibilities
Education and Experience | Bachelor’s degree in Finance, Economics, or related field, preferred;
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Special Skills, Licenses and Certifications | Knowledge of managed care finance principles and medical coding,
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Performance Based Competencies | Excellent oral and written communication skills. Strong project
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Work Environment And Physical Demands | Ability to use a computer keyboard and 10-key calculator. Ability to
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All HealthPlan employees are expected to:
HIRING RANGE:
$118,518.94 - $154,074.63
IMPORTANT DISCLAIMER NOTICE
The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.
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