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).
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 Company’s 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 compliance-related processes in Company’s 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 in-services 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 Company’s 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 co-workers 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
Medical, Dental, and Vision Insurance
Paid Time Off and Paid Sick Time
401(k)
Referral Program
Pay Range: $80,000 - $90,000 / 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 employment-at-will employer.