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Medicaid / CHIP Data Processing Review SME
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- Serco is seeking a motivated Data Processing subject Matter Expert to join our talented and fast-paced Public Sector Solutions team in supporting CMS’ implementation of the Payment Error Rate Measurement (PERM) Program to produce national Medicaid and Children’s Health Insurance Program (CHIP) improper payment estimates as required by the Payment Integrity Information Act of 2019 (PIIA).
- The Data Processing Subject Matter Expert position would be responsible to provide expertise and overall review support to teams in overseeing, reviewing, researching, and investigating claims processing systems and processes.
- Provide expertise or general claims support to teams in reviewing, researching, and investigating claims processing systems and processes to ensure quality claims data review to meet requirements of the PERM program.
- Knowledge and expertise in managed care claims, third-party liability, Medicaid waiver programs, and/or provider enrollment.
- Knowledge and expertise in working with states’ claims processing systems (including MMIS), payment policy, payment systems, coding, billing, and compliance rules in Medicaid and CHIP.
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