[Hiring] Senior Compliance Specialist @FreedomCare

Role Description

We are looking for a Sr. Compliance Specialist for our Compliance team.

The Compliance Specialist role will encompass a wide range of responsibilities that will aid the department in maintaining regulatory requirements.

Every Day You Will:

• Conduct and respond to internal and external audits for all jurisdictions
• Assist with conflict reporting and collaborate with our finance department to resolve conflicts
• Subpoena medical records and general record requests
• Investigate fraud, waste & abuse claims
• Make suggestions on next steps of FWA claims
• Be a resource for escalated concerns for all active states
• Quality assurance review
• All other compliance duties as assigned

Qualifications

• Bachelor’s degree and a minimum of 3 years of experience in the healthcare industry, or
• Associate degree and a minimum of 5 years experience in the healthcare industry
• Extensive knowledge of Medicaid regulations
• Experience with exclusion screening and background checks
• Extensive knowledge of billing and coding preferred

Requirements

• Ability to exercise good judgment in using knowledge of best practices, regulations, and business processes
• Ability to work with limited supervision on complex matters; self-starter and takes initiative
• Demonstrated ability to be detail-oriented and thorough
• Reliable and detail-oriented
• Adept at multi-tasking
• Prior experience with internal and external audits

Benefits

• Competitive compensation
• Medical benefits
• Retirement plans
• Wellness programs
• Fun company events
• Ongoing learning opportunities to grow your career