Taking Care of Our Nation’s Veterans.
It’s Who We Are. It’s What We Do.
Do you have a passion for serving those who served?
Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!
Our job is to make sure that America’s heroes get connected to health care in the community.
At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.
Are you our next Program Integrity Support Specialist?
This position is under general guidance of the Director, Corporate Compliance and reports directly to the Supervisor, PI Specialist. The PI Support Specialist is responsible for providing claim processing and administrative support for Program Integrity (PI) investigations, law enforcement requests for information, other internal/external Fraud, Waste and Abuse (FWA) case development activities. The PI Support Specialist utilizes healthcare billing, claim processing, and medical record knowledge, in addition to research skills, to review and process of medical/surgical and behavioral health claims according to protocol directions established by PI Specialist. The PI Support Specialist captures savings and recoupment calculations, and reports on PI provider flag efficiencies. The PI Support Specialist compiles claim data, provider contracts, bank accounts, patient files (including, but not limited to medical records and claim images) and other information necessary to respond to law enforcement subpoenas related to FWA investigations. The PI Support Specialist accurately records case referrals, claim activity, and law enforcement information requests, and assists the PI Supervisor with departmental reporting requirements. Ensures strict compliance with court appearance deadlines and HIPAA Privacy Rules.
TriWest Program Integrity Support Specialist:
Are you qualified?
More about working at TriWest Healthcare Alliance
We’re more than just a health care company. We’re passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:
Equal Opportunity Employer
TriWest Healthcare Alliance is an equal employment opportunity employer. All qualified applicants are considered for employment, without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic made unlawful by applicable federal, state, or local laws.
Are you ready to make a difference in the lives of our nation’s heroes?
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