Administrative Action Specialist

Responsibilities SafeGuard Services (SGS), a subsidiary of Peraton , performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse. We are looking to add an Admin Action Specialist to our SGS team of talented professionals. What you'll do: The Admin Action Specialist is responsible for being a Point of Contact for CMS regarding all administrative actions related to investigations. Developing and submitting an action to CMS for approval. Maintaining a high-volume workload that requires quick actions and multiple metrics. Review and verify evidence supporting administrative action as it relates to payment suspensions, revocations, overpayments as well as other administrative actions that can be pursued (payment suspension, revocation, prepayment edits, auto-denial edits). Work with the Investigative Teams to ensure that the documentation gathered is sufficient to support an administrative action. Work with CMS, law enforcement and the Medicare Administrative Contractor throughout the life of the action. Monitor workload to ensure all actions are taken within the required timeframes set forth in the …