About Fallon Health:
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org.
Brief summary of purpose:
Under the general supervision of the Provider Data Manager, will perform an audit sampling of Provider Data within the eVIPS application. Prepares audit summaries and sign off for staff and managers. Identifies trends in errors and recommends improved processes and/or training needs.
Resources (systems, etc) used in performing role
Bachelor’s degree preferred and/or similar work experience
Minimum of 3 years’ experience in health care and 2-3 years in an auditing or analytical related field. Proficiency in Excel and Access including experience in comparing files. Knowledge of provider data.