DC Department of Human Resources · 6 hours ago
Program Support Specialist
Washington, DC
Full-time
Onsite
Entry Level
1+ years expThe DC Department of Human Resources is seeking a Program Support Specialist for the Office of Risk Management. The role involves providing programmatic and administrative support primarily focused on medical bill review and payment activities related to workers' compensation claims.
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Responsibilities
Provides programmatic and administrative support to the Compliance Team with primary responsibility for medical bill review and payment support activities
Reviews workers’ compensation medical bills and related documentation to ensure accuracy, completeness, and compliance with applicable District and federal statutes, established fee schedules, treatment guidelines, and Office of Risk Management (ORM) policies and procedures
Identifies billing discrepancies, duplicate or non-covered charges, and coding or documentation issues, and coordinates with claims staff, nurse case managers, fiscal staff, third-party administrators, and medical providers to support timely and accurate resolution and payment
Collects, tracks, and maintains medical billing data and supporting documentation; prepares spreadsheets, logs, and summary reports to support compliance monitoring, audits, and management review
Assists with responding to internal and external inquiries related to billing activity and payment status
Supports quality assurance efforts and internal control reviews by assisting in the evaluation of procedures and workflows related to medical bill review, recommending administrative improvements, and preparing routine correspondence and documentation
Maintains accurate records in accordance with retention requirements, uses automated systems and Microsoft Office applications to support daily operations, and performs other related duties as assigned in support of Compliance Team and ORM operations
Qualification
Required
Experience that equipped the applicant with the particular knowledge, skills and abilities to perform successfully the duties of the position, and this is typically in or related to the work of the position to be filled
At least one (1) year of specialized experience must have been equivalent to at least the next lower grade level in the normal line of progression for the occupation in the organization
Ability to review, analyze, and process workers' compensation medical invoices to ensure accuracy, compliance with statutory and regulatory requirements, established fee schedules, and ORM policies and procedures
Ability to identify billing discrepancies, duplicate or non-covered charges, and coding or documentation issues
Ability to coordinate with claims staff, nurse case managers, fiscal staff, third-party administrators, and medical providers to support timely and accurate resolution and payment
Ability to collect, track, and maintain medical billing data and supporting documentation
Ability to prepare spreadsheets, logs, and summary reports to support compliance monitoring, audits, and management review
Ability to assist with responding to internal and external inquiries related to billing activity and payment status
Ability to support quality assurance efforts and internal control reviews by assisting in the evaluation of procedures and workflows related to medical bill review
Ability to recommend administrative improvements and prepare routine correspondence and documentation
Ability to maintain accurate records in accordance with retention requirements
Ability to use automated systems and Microsoft Office applications to support daily operations
Ability to perform other related duties as assigned in support of Compliance Team and ORM operations
Company
DC Department of Human Resources
At the District of Columbia’s Department of Human Resources, we believe that people are the heart of public service.
10001+ employees
H1B Sponsorship
DC Department of Human Resources has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2024 (9)
2023 (2)
2022 (1)
2021 (2)
2020 (5)
Funding
Current Stage
Late StageLeadership Team
Absala Mengestab
Chief Information Officer
Kristina Savoy
Chief Learning Officer
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