Job Description
Key Responsibilities :
- Evaluate child/youth’s case for compliance to applicable regulations.
- Clearly communicate evaluation requirements and follow up.
- Evaluate documentation against applicable regulations.
- Collect data and documentation to support compliance findings.
- Utilize technology to convert hard copy documentation to electronic and submit via secure file transfer.
- Record, summarize, and communicate compliance findings
- Assist in determining trends in non-compliance.
- Make appropriate and timely recommendations to project management.
- Assist with the ongoing operationalization of project’s processes and procedures.
- Assist with all internal and external reporting.
- Build and maintain relationships with stakeholders to provide a high level of customer service.
- Traveling to provider sites to perform case reviews.
Required Qualifications:
- Bachelor’s degree in public health, healthcare management, psychology, human services, or related field.
- A minimum of 2 years of A minimum of 2 years of experience as a Healthcare Compliance Analyst, Auditor, Care Manager, or Medicaid Provider, in a role responsible for conducting oversight, compliance audits or chart reviews, or ensuring quality of care.
- An equivalent combination of advanced education, training, and experience will be considered.
- Experience with Medicaid fee-for-service and/or Managed Care billing.
- Proficiency in MS Excel, MS Word, MS Outlook, MS Visio, MS PowerPoint and MS SharePoint.
Preferred/Desired Qualifications:
- Extensive knowledge of, and experience with, Home and Community-Based Services Waiver programs, either as a provider or compliance officer.
- Experience with Medicaid billing, including the use of various Electronic Health Records (EHR) systems.
- Experience with compliance audits or chart reviews.
- Ability to work with and relate to staff and demonstrate active listening skills.
- Process oriented and results-driven work strategy.
- Ability to foster teamwork with all levels of management and staff.
- Ability to work well independently and within a team.
- Exceptional customer service relationship techniques, including superior verbal and written communication skills.
- Excellent accuracy and attention to detail.
- Experience in meeting deadlines and adhering to strict standards of performance.
GENESYS Consulting Services, Inc. is proud to be an equal-opportunity employer.
Job Tags
Contract work, Work from home,