NCI: As the Benefit Integrity Supervisor (Benefit Integrity Supervisor) for AdvanceMed, a subsidiary of NCI, you will be responsible for overseeing activities related to fraud investigation development, support for law enforcement, and ensuring BI Analysts provide support of post-referral cases. The BI Supervisor oversees the day-to-day operations of Benefit Integrity staff.
Highlights of Responsibilities:
- Responsible for prioritization and assignment of workload, ensuring adherence to ZPIC policies and procedures.
- Works with investigators to develops plans of action for investigation development and information request processing.
- Responsible for meeting quality and production standards.
- Produces and submits required reports according to pre-established time guidelines.
- Monitors security of evidence gathered during the development of fraud investigations.
- Helps in establishing and maintaining relationships with outside law enforcement agencies.
- Works closely with the Data Analysts to identify and develop proactive fraud leads through investigation of identified leads.
- Ensuring the departmental compliance with Quality Management System and ISO requirements.
- Responsible for the aggressive application of administrative actions during investigation development (including overpayment identification, payment suspension, referral for civil monetary penalties).
- Hires and manages BI staff.
- Responsible for the timely completion of annual employee performance assessments and, when necessary, employee counseling.
- Conducts matrix review meetings with investigators to ensure thorough and timely fraud investigations in accordance with ZPIC guidelines.
- Works to facilitate training of investigation-related skills development for BI Analysts to raise the level of knowledge and quality of investigative work performed by the ZPIC.
Preferred Education and Experience:
- A Bachelor’s Degree or 10 years of equivalent experience in a related field.
- Minimum of 2-3 years of experience in Medicare fraud investigations including investigation development, data analysis, and problem identification.
- Excellent oral, written and verbal skills.
- Ability to work independently and with minimal supervision.
- Must have and maintain a valid driver’s license issued by the state of residence
- Candidates that have attained their Certified Fraud Examiner’s (CFE) Certification.
- Knowledge of statistics, data analysis techniques, and PC skills.
At NCI, we’re more than just a paycheck…
We offer significant opportunity for growth at NCI – Adding more and more employees and company locations nationwide, we continue to seek top talent to ensure our path of innovation, growth and unmatched customer experience. We reward our employees with competitive compensation, flexible time off, retirement plan with company match and much more…
MEDICAL/DENTAL/VISION PROGRAMS - NCI offers three medical plan options to meet the personal health needs and budgets of our full-time employees and their families. All plans provide our employees and their eligible dependents with major medical and prescription drug coverage. The dental plan provides coverage options so as to ensure our full-time employees and their eligible dependents are able to follow a regularly scheduled program of dental care with their providers of choice. A vision maintenance plan offers a cost-savings option for our full-time employees and their families in need of comprehensive annual eye exams, prescription glasses, and contact lenses.
STOCK & WEALTH - NCI’s 401(k) Profit Sharing Plan is eligible to all full-time and regular part-time employees. Employees may elect to have contributions invested in any of the 15 different investment funds, five retirement-date-based funds, or three different portfolio options available under the plan. The company matching contribution is equal to 50% of employee elected pre-tax contributions up to 6% of eligible pay, subject to the IRS maximum.
LIFE INSURANCE - NCI provides company paid Basic Life/ AD&D Insurance Coverage. The basic coverage benefit is equal to one times (1X) an employee's annual base salary. Employees may also opt for a generous flat rate insurance coverage. For coverage above the company-provided limits, employees may purchase supplemental insurance coverage for themselves and their family members.
WORK/LIFE BALANCE - All employees are eligible for additional programs including Paid Time Off (PTO).
- Flexible Spending Programs
- Employee Assistance Program (EAP) for employees and their immediate family
- Health Club Reimbursement through NCI’s Wellness Program
It is your turn… Choose your career path and become part of the NCI team where you will be valued for your unique skills and capabilities and where you will be rewarded for key contributions to NCI and our customers.
Make the commitment and take the next step towards joining the NCI Team. Our application process will take approximately 5-10 minutes to complete.
If you do not meet the minimum qualifications for this position, please review our current openings now and in the future. Thank you for your interest in NCI!
It is the policy of NCI to provide equal opportunity in recruiting, hiring, training, and promoting individuals in all job categories without regard to race, color, religion, national origin, gender, age, sexual orientation, disability or veteran status.
The information above has been designed to indicate the general nature and level of work performed by employees within the classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to this position.
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