Remote Administrative Action Lead - Investigations & Workflow

Peraton; Herndon (VA); Remote; USD 66,000 - 106,000; Full time

Job summary

SafeGuard Services (SGS), a Peraton subsidiary, seeks an Administrative Action Specialist Team Lead to guide a team responsible for investigating and developing administrative actions within complex investigations.

The role requires mentoring staff, managing workloads, ensuring timely action development, and applying regulatory knowledge to pursue actions. Telework is available from the East Coast; US citizenship is required.

Qualifications

• Minimum of 8 years with BS/BA or 12 years of experience and a HS Diploma.
• 8 years of relevant investigative experience required.
• Knowledge of Medicare requirements, laws, rules and regulations related to payment of services billed to the Program.
• Medicare claims processing knowledge.
• Strong communication and organization skills.
• US citizenship required.

Responsibilities

• Act as a point of contact for manager.
• Work with CMS on proceeding with and finalizing administrative actions.
• Assist team members with workflow and admin action development.
• Review workloads during workload meetings; assist with prioritizing and conduct QC for staff.
• Monitor the quality of WMM/UCM and timeliness for case updates.
• Mentor team members to develop actions efficiently.
• Participate in CMS high-priority projects and provide team direction.
• Develop an efficient workflow process and evaluate effectiveness.
• Telework available from East Coast.

Skills

Communication skills

Organizational skills

PC literacy

US citizenship

Investigation knowledge

Education

BS/BA or 12 years exp w HS Diploma

Tools

Medicare claims processing

Job description

SafeGuard Services (SGS), a Peraton subsidiary, seeks an Administrative Action Specialist Team Lead to guide a team responsible for investigating and developing administrative actions within complex investigations.

The role requires mentoring staff, managing workloads, ensuring timely action development, and applying regulatory knowledge to pursue actions. Telework is available from the East Coast; US citizenship is required.