Min
USD $65,000.00/Yr.
Max
USD $80,000.00/Yr.
Position Overview
SUS is seeking a Compliance Specialist within their QA department.
This position is located at 7th Avenue New York, NY 10018.
SCOPE OF ROLE :
The Support Services functions at S:US are carried out by a team of professionals with differing
backgrounds who share deeply in the S:US mission. We provide resources and support to the
program departments to collectively pursue that mission. Support Services is a collegial, supportive and dynamic culture that continuously seeks to improve. We strive to treat all staff with respect in each interaction. We are motivated to accomplish our individual and collective tasks by the belief that we can help transform the lives of people we serve thereby righting societal imbalances.
As a Compliance Specialist, you will be joining a dynamic department that protects the organization as well as the people we serve. Specifically, your role will be to implement and develop regulatory compliance strategies, provide technical support to program staff (including trainings), and conduct targeted reviews, internal audits, and compliance investigations. The Compliance Specialist is responsible for preparing written reports summarizing review findings, reporting such findings to the Vice President of Quality Assurance and the Chief Corporate Compliance officer, and making recommendations for improvement and correction where identified.
ESSENTIAL DUTIES & RESPONSIBILITIES:
Audits/Reviews
Conduct Medicaid billing reviews to ensure documentation exists to support billing
Review and audit the quality of clinical case documentation and services
Conduct site visits to ensure compliance with all regulatory mandates
Conduct follow-up audits to confirm corrective actions have been implemented and are effective
Draft written reports summarizing findings of various audits/reviews
Help to develop audit tools to be used in various audits/reviews
Trainings
Conduct compliance/documentation trainings for staff
Help to develop and update training materials for compliance/documentation trainings Compliance Investigations
Conduct investigations regarding regulatory and compliance issues
Draft investigation reports summarizing findings and recommending corrective actions Compliance Support
Provide technical assistance to staff when questions arise regarding documentation requirements or other compliance related issues
Develop, review, analyze and improve internal controls and monitoring systems for various programs/departments
Identify compliance risk areas and assist with the development and implementation of policies and corrective action plans where indicated
Attend inter-departmental meetings representing the quality assurance department to ensure compliance with regulatory mandates
Attend external meetings and trainings representing the agency at various trade associations
Perform other duties as required
KEY RESPONSIBILITIES:
Communication: Ability to communicate effectively and demonstrate good interpersonal and professional skills when interacting with individuals served, co-workers, and management. Maintain open communication with your supervisor as it relates to the completion and accuracy of assignments. Listen and respond appropriately to others’ ideas, make suggestions and offer alternative solutions, and give and receive honest, constructive feedback.
Quality of Work: Assignments are accurate, complete, timely, and comply with agency and department policies and procedures. Independently work towards overcoming challenges and barriers to accomplish performance objectives. Complete an acceptable quantity of work within deadlines, while maintaining the required quality and accuracy of the work.
Integrity/Compliance: Uphold personal and professional ethics and values, considering the values of the organization and respecting the culture, beliefs and abilities of individuals we Ensure compliance with HIPPA and other regulatory requirements for responsible…