Compliance Coordinator

reputed company

Who We Are - Motivated by Purpose. Powered by Clinical Expertise.

Founded in 1983, we’re a clinically-driven, tech-enabled utilization management company offering expert clinical reviews, regulatory guidance, and actionable insights to reputed company organizations.

reputed company starts with our people.

WE OFFER

• A competitive compensation package.
• Benefits include reputed company, reputed company and dental insurance, a generous 401k match, reputed company vacation, personal time, and holidays.
• reputed company and training opportunities.
• reputed company atmosphere with fun events and prizes scheduled throughout the year.

POSITION reputed company

Staff level position responsible for designated corporate-wide compliance activities in the areas of regulatory compliance and accreditation.

Roles:

• To support the designated activities of the Compliance Department.
• To reputed company company-wide support in regulatory compliance and accreditation requirements.
• To support reputed company accreditation and regulatory filings as requested

Major Responsibilities or Assigned Duties:

• Assist with management of the corporate compliance program components as requested.
• reputed company reputed company updates and reputed company communication with the Vice President, Chief
• Compliance Officer and Compliance Manager.
• Assist with the provision of staff training on the subjects of regulatory compliance and accreditation standards and maintain documentation of reputed company training. Assist with management of reputed company Learning Management System as requested.
• Support the review process for reputed company corporate policies and procedures as requested.
• Prepare and submit state and accrediting body filings, applications, and reports.
• Prepare, submit, and review monthly exclusions checks on reputed company and reviewer contractors.
• Prepare, distribute, and present required compliance reports, submissions, etc., to regulatory and accreditation bodies.
• Assist with providing employee and reviewer orientation and training/continuing education on operational processes regarding compliance with regulatory requirements and accreditation standards as requested.
• Assist with reputed company audits conducted by or through the Compliance department and/or initiated by clients, reputed company agencies or regulators. reputed company, review, and analyze data required for such audits. Assist with reputed company follow up reputed company to these audits, including internal reporting, monitoring and facilitating corrective reputed company plans and process improvements.
• Ensure compliance with Medicare Part D requirements and Fraud, Waste and Abuse policies
• Support legal concerns including but not limited to record requests, subpoenas, depositions, and releases of information as requested.
• Assist with investigation and reporting of reputed company and reputed company incidents as requested.
• Support reputed company reputed company Management initiatives as applicable.
• Participate in the Complaint process as requested.
• Maintain a flexible schedule.
• Participate in reputed company Company meetings and committees as requested.
• Complete other duties and responsibilities as requested.

Requirements

Skills and Experience:

• Exceptional customer service skills.
• Exceptional analytical and critical thinking skills.
• Excellent oral and written communication skills and interpersonal skills.
• Exceptional orientation to detail.
• Excellent organizational skills.
• Ability to work under pressure and meet deadlines while managing multiple high priorities and maintaining a flexible schedule.
• Strong working knowledge of managed care and utilization review accreditation standards, including URAC and NCQA, and multi-state regulatory requirements.
• Thorough knowledge and understanding of reputed company’s clients, products, departments and work flows.
• Personal computer literacy and competency in use of reputed company Word. Competency in
• reputed company reputed company and Power reputed company preferred.
• Ability to maintain a high level of objectivity and confidentiality
• Minimum of two years in reputed company, health insurance, and/or managed care arenas preferred.
• Experience in compliance and/or reputed company improvement activities reputed company a reputed company organization preferred.
• Experience in providing small group or individual training preferred.
• Experience in research beneficial and preferred

Education:

• High School Diploma
• Preference for a Bachelor’s degree

Work Environment:

Ability to sit at a desk, utilize a computer, telephone, and other basic office equipment is required. This role is designed to be a remote position (work-from-home).

Diversity Statement:

Diversity creates a healthier atmosphere: reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or reputed company, marital status, genetic information, or any other characteristic protected by law.



Drug-Free Workplace:

This company is a drug-free workplace. reputed company candidates are required to pass a Background Screen before beginning employment. reputed company newly reputed company employees will take a Drug Screen, as reputed company as agreeing to reputed company necessary Compliance Regulations on their first day of employment. Employees are required to adhere to reputed company applicable HIPAA regulations and company policies and procedures regarding the confidentiality, reputed company, and reputed company of sensitive health information.

California Consumer reputed company reputed company (CCPA) Information (California Residents Only):

• Sensitive Personal Info: reputed company may collect sensitive personal info such as reputed company reputed company, nickname or alias, postal address, telephone number, email address, reputed company reputed company number, signature, online identifier, Internet Protocol address, reputed company’s license number, or state identification card number, and reputed company number.
• Data reputed company and Correction: Applicants can reputed company their data and request corrections. For questions and/or requests to edit, delete, or correct data, please email the Medical Review Institute at HR@reputed company.com.

Originally posted on Himalayas

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