Regulatory Compliance Administrator

The Regulatory Compliance Administrator (CAM) manages corporate compliance with all federal and state regulations pertaining to healthcare licensure certification accreditation and auditing; and assists with facilitation of employee compliance to the company Compliance Program. In this role you will report to the Chief Compliance Officer (CCO).

Duties/Responsibilities:

• Completes licensure and certification initial renewals and changes in compliance with all State and Federal regulations

• Maintains up to date knowledge of State and Federal regulations to affect efficient maintenance of changes to acquisition of licensure and certification

• Assists with conducting auditing and monitoring activities related to the company compliance program

• Manages/coordinates any external audits that may occur along with the billing clinical and auditing departments

• Provides support and consultation to Clinical Operations and Human Resources departments during external site audits

• Assists the Contracting department to approve and credential new and existing contracts by managing regulatory compliance components

• Understands the Companys policies and procedures

• Assists with development of materials and compliance related policies and implementation of Compliance initiatives and/or program requirements

• Assists in updating company compliance policies and procedures and communicating with education department to ensure that staff are educated to these policies and procedures updates

• Makes recommendations directly to the CCO and other staff regarding corrective action in order to prevent or remedy fraudulent or abusive conduct

• Assists in managing and responding to compliance inquiries and incidents and participates in root cause analyses

• Facilitates integration of compliancerelated processes in Companys business departments and systems

• Ensures appropriate retention of records related to the Compliance Program

• Functions as member of Compliance Committee Policy and Procedure Committee Process and Forms Committee Executive Committee and Budget Committee

• Maintains strict confidentiality of all internal and external compliance matters

• Supports continuous education to all employees regarding compliance

• Participates in annual risk assessments and compilation of Compliance Work Plan

• Monitors along with HR the provisions of the Deficit Reduction Act (DRA) for the commercial Medicaid division

• Participates in specialized training activities regarding various types of violations applicable to home health care and effective tools to utilize to avoid fraudulent and abusive conduct

• Works with various departments to ensure collection and submission of data to appropriate federal and state licensure entities in a timely manner

• Attends inservices and continuing education as applicable

• Understands the role and responsibilities of the HIPAA Privacy and Security Officers and ensures they function according to the Compliance Plan

• Performs and maintains fair market value analyses

• Constructs contracts if required for referral clinical affiliation property or staffing arrangements

• Other responsibilities as assigned

Required Skills/Abilities/Knowledge:

• Excellent verbal and written communication skills with ability to communicate across all levels of authority

• Excellent organization problem solving and project management skills

• Ability to learn absorb and apply professional training

• Excellent knowledge of Medicare/Medicaid licensure on the state and federal levels (CMS and other government payer agencies)

• Able to work with multiple teams within the organization to promote viable ethical and cost effective solutions

• Able to effectively deal with change

• Must be able to complete projects within specific timetables

• Awareness of all aspects of the Companys Compliance Program Compliance Plan and Compliance Work Plan

• Familiarity with HIPAA Privacy and Security Rules

• Requires the ability to use logical and scientific thinking to interpret technical data and solve a broad range of problems including the ability to use complex techniques to assess situations

• Requires the ability to interpret adapt and react calmly under stressful conditions

• Must be able to relate cooperatively and constructively with clients and coworkers and effectively monitor and develop the abilities of subordinates

• Requires the ability to communicate verbally and in writing and to maintain confidentiality of sensitive information

• Strong computer skills including Outlook Excel Word and Power Point

Education/Experience/Licenses/Certifications:

• Two to four years of experience in healthcare billing audit or compliance related work
  
  

Benefits Perks of Joining the Team Select Family

• Medical Dental and Vision Insurance

• Paid Time Off and Paid Sick Time

• 401(k)

• Referral Program

Pay Range: $80000 $90000 / salary

Team Select Home Care reserves the right to change the above job description and qualifications without notice. Team Select Home Care will not discriminate against you on the basis of race color religion national origin sex sexual preference disability political belief veteran status age or any other status protected by law. Team Select Home Care is an employmentatwill employer.