CLEARANCE: Public Trust **This position requires a Public Trust clearance active on day one of performance.** REQUISITION NUMBER: 120717.01-C10p FUNCTIONAL / LABOR CATEGORY: Program Manager POSITION TITLE: Manager LOCATION: TBD- Remote Location- Telework capabilities available
Sehlke Consulting is now hiring a Program Manager to oversee a compliance assessment team supporting the Department of Veteran’s Affairs. The main objective is to ensure the accuracy of medical billing. The goal is to protect against fraudulent claims and billing activity, to remedy over-coding, bad unbundling habits, code overuse, and to bill appropriately for documented procedures.
EDUCATION: • Bachelor's degree in Accounting or related field
CERTIFICATION(s): Project Management Professional (PMP), Certified Public Accountant (CPA), or Certified Fraud Examiners (CFE) designation
LABOR CATEGORY / DUTIES:
• Ensure appropriate methodology to include financial controls, identification of trends and unusual patterns, reimbursement deficiencies, and to improve processes. • Ensure that appropriate services are provided in accordance with examination protocol and medical billing practices. • Ensure vendor billing processes maintain appropriate financial internal controls to review and adjust charges prior to invoicing the VA. • Identify unusual examiner patterns based on trends identifiable to the vendor/provider identification number. • Identify deficiencies in the reimbursement process and opportunities for appropriate reimbursement. • Provide a detailed report listing the findings and any adjustments required to the invoices for all inappropriately invoiced services. • Make recommendations for improvements in processes or policies.
• At least 5 years of experience in a supervisory position. • At least 5 years in conducting billing audits/assessments preferably specific to medical billing. • Knowledge of audit processes involving medical terminology. • Program Manager experience within Veteran Affairs Benefits/Health Administration or Human Health Services.
Founded in 2011, Sehlke Consulting is a rapidly-growing Service-Disabled Veteran-Owned Small Business (SDVOSB) and Historically Underutilized Business Zone (HUBZone) headquartered in Arlington, VA – and an Equal Opportunity Employer that values the strength diversity brings to the workplace. Individuals with Disabilities and Protected Veterans are encouraged to apply.