Community Options, Inc. is a national non-profit agency providing services to individuals with disabilities in 12 states.
We are now hiring a Full-Time
Compliance Specialist
in
Tempe, AZ . The Compliance Specialist is responsible for monitoring billing records to ensure compliance with Federal and State regulations for the Centers for Medicare & Medicaid Services and HHS requirements through billing, identifying potential errors, and recommending corrective actions by reviewing individual records, billing codes, and documentation. This person will be held accountable for ensuring the appropriate implementation of policies and procedures, and ensuring programs are completely in compliance with federal and state rules, regulations, and agency policies. This role requires leveraging data insights to enhance compliance processes and reporting.
Responsibilities
Conduct audits of financial and personnel files to include training records, electronic health records, and billing documentation
Conduct comprehensive record reviews
Utilize data analytics to monitor, assess, and identify compliance risks, trends, and areas for improvement.
Performs claims review
Examine billing codes for accuracy, including proper modifiers
Investigate reports of potential non-compliance and provide comprehensive reports on findings with recommendations
Submit reports, dashboards, and presentations using Microsoft Office and business intelligence tools to the Compliance Manager
Communicate findings of audits to the Compliance Manager and Director of Data Analytics
Maintain a master file of all audits
Keep up-to-date with applicable laws, regulatory requirements, and best practices
Additional tasks and responsibilities may be assigned
Minimum Requirements
Bachelor’s degree in healthcare administration, accounting, or a related field and three years of relevant experience
Valid driver’s license with a satisfactory driving record
Experience with billing practices and guidelines
Understanding of Medicaid regulations
Ability to present facts and recommendations effectively in oral and written form
Independent judgment is required to plan, prioritize, and organize diversified workload
Strong proficiency in Microsoft Office, particularly Excel
Knowledge and understanding of local regulatory agency operations
Employment is contingent upon successful completion of checks of criminal background, central registry, child abuse registry, and drug testing
Why Community Options?
Competitive Insurance Benefits (Medical, Dental, Vision)
Paid Holidays—Including a Birthday Holiday
Generous PTO
Employee Incentive & Discount Programs
403b Retirement Plan
Incredible career growth opportunities
University partnerships that include tuition reduction
Community Options is an Equal Opportunity Employer M/F/D/V
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We are now hiring a Full-Time
Compliance Specialist
in
Tempe, AZ . The Compliance Specialist is responsible for monitoring billing records to ensure compliance with Federal and State regulations for the Centers for Medicare & Medicaid Services and HHS requirements through billing, identifying potential errors, and recommending corrective actions by reviewing individual records, billing codes, and documentation. This person will be held accountable for ensuring the appropriate implementation of policies and procedures, and ensuring programs are completely in compliance with federal and state rules, regulations, and agency policies. This role requires leveraging data insights to enhance compliance processes and reporting.
Responsibilities
Conduct audits of financial and personnel files to include training records, electronic health records, and billing documentation
Conduct comprehensive record reviews
Utilize data analytics to monitor, assess, and identify compliance risks, trends, and areas for improvement.
Performs claims review
Examine billing codes for accuracy, including proper modifiers
Investigate reports of potential non-compliance and provide comprehensive reports on findings with recommendations
Submit reports, dashboards, and presentations using Microsoft Office and business intelligence tools to the Compliance Manager
Communicate findings of audits to the Compliance Manager and Director of Data Analytics
Maintain a master file of all audits
Keep up-to-date with applicable laws, regulatory requirements, and best practices
Additional tasks and responsibilities may be assigned
Minimum Requirements
Bachelor’s degree in healthcare administration, accounting, or a related field and three years of relevant experience
Valid driver’s license with a satisfactory driving record
Experience with billing practices and guidelines
Understanding of Medicaid regulations
Ability to present facts and recommendations effectively in oral and written form
Independent judgment is required to plan, prioritize, and organize diversified workload
Strong proficiency in Microsoft Office, particularly Excel
Knowledge and understanding of local regulatory agency operations
Employment is contingent upon successful completion of checks of criminal background, central registry, child abuse registry, and drug testing
Why Community Options?
Competitive Insurance Benefits (Medical, Dental, Vision)
Paid Holidays—Including a Birthday Holiday
Generous PTO
Employee Incentive & Discount Programs
403b Retirement Plan
Incredible career growth opportunities
University partnerships that include tuition reduction
Community Options is an Equal Opportunity Employer M/F/D/V
#J-18808-Ljbffr