Program Specialist - Recovery and Cost Avoidance
$51,709–$51,709 year
On-siteLincoln, Nebraska, United States
Job Summary
Review health insurance benefit plans, explanation of benefits, and medical claims history to verify, approve, and issue reimbursements while coordinating the development and evaluation of statewide health programs. Serve as a consultant to agency staff, clients, and service providers by providing technical assistance on policy interpretation and program administration. Conduct quality assurance analysis and research to develop program policies, ensuring Medicaid maximizes funds and reduces costs through Coordination of Benefits, Estate Recovery, Health Insurance Premium Payment, and Third Party Liability initiatives. Prepare technical documents, action plans, and reports on state and federal regulations.
Required Qualifications
- Bachelor's degree, or equivalent coursework/training, in public administration, social/behavioral sciences, healthcare, human services or other program related field
- Professional experience working in a human/social service or health care agency with responsibility for planning or evaluation services, programs or operational policies and practices
- Familiarity with Microsoft Office, Teams, Excel, PowerPoint, or similar tools
Desired Qualifications
- A bachelor's degree in social sciences, education, or a related field
- Experience with medical claims/insurance claim coordination, medical office administration
- Experience reading/interpreting insurance policies
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