Program Integrity Analyst

Program Integrity Analyst CATEGORY: Clinical Review REQUISITION NUMBER: PROGR001299 LOCATION: Seattle, WA 98109, USA Post Program Integrity Analyst Job Category: Clinical Review Requisition Number: PROGR001299 Apply now Posting Details - - Posted: October 30, 2024 Full-Time Locations Showing 1 location Seattle 400 Fairview Ave N Suite 800 Seattle, WA 98109, USA Seattle 400 Fairview Ave N Suite 800 Seattle, WA 98109, USA Spokane 611 N. Iron Bridge Way Suite 200 Spokane, WA 99202, USA Spokane 611 N. Iron Bridge Way Suite 200 Spokane, WA 99202, USA Colville 720 South Washington Street Colville, WA 99114, USA Colville 720 South Washington Street Colville, WA 99114, USA [2 more locations]{tabindex"0"} Job Details Description We are looking for a Program Integrity Analyst to play a big role in safeguarding DDWA purchasers and programs from fraud, abuse, overbilling, misrepresentation, waste and/or violation of contract or law to minimize exposure to financial loss. This position will also support our Providers by building trust through professional, timely and transparent correspondence, informative outreach and audit follow up, and continual assessment of program thresholds and benchmarks to further improve the provider experience. At Delta Dental of Washington our vision is that all people can enjoy good oral and overall health, with no one left behind. We succeed because of a shared commitment to a set of values that guide everything we do for our customers, for our communities, and for each other. We are Accountable. We lean in with Courage. We stay Curious. We are Inclusive. We act with Integrity. We offer a highly competitive medical, dental and vision plans as well offering a generous 401k match and all employees start accruing vacation and sick time from their very first day. We empower employee development through our tuition reimbursement plan, professional development plans, and employee-led communities. The pay range for this position In Western Washington varies between $60,435.00 $84,533.00, and for Eastern Washington varies between $53,720.00 - $75,140.00. Washington Dental Service and its affiliates, including Delta Dental of Washington and Arcora Foundation intends to offer the selected candidate a base pay within this range, dependent on job-related, non-discriminatory factors such as experience. Base pay will also be adjusted based on the candidate's geographic location. Essential Responsibilities include the following: The list of responsibilities listed is not intended to be comprehensive. Washington Dental Service and its affiliates, including Arcora Foundation, Delta Dental of Washington, and TriForza reserve the right to change the responsibilities at any time with or without notice. Maintains a program that identifies and prevents Fraud, Waste and Abuse. Investigate dental office claim/billing procedures, group/ employer, broker and patient activities (including internal fraud investigations) and follows through on all instances where a claim appears to be fraudulently submitted. Reviews