Job Description
Overview:
The Compliance Specialist’s primary responsibility is the assurance of Medicaid policies & procedures across all Arrow Health Solutions (AHS) services. These processes will inform and improve practices that have a direct impact on services to children, families, and compliance. This position is responsible for developing systems for routine evaluation, tracking performance, and establishing a consistent feedback loop. This position will assist program leadership in administrative and strategic tasks.
Benefits Include: - Medical, dental, vision, and supplemental insurance options, including HSA match for qualifying contributions.
- Parental Paid Leave
- Retirement savings plan with company match.
- Paid time off and holiday pay.
- Mileage reimbursement.
- Tuition reimbursement available.
- Company sponsored learning and development
Other duties may be assigned as necessary.
- Develop, implement, and maintain system for tracking sales order, compliance with MCO contracts.
- Develop tools for evaluating compliance in member, client records that mirrors state contract monitoring.
- Implement and maintain a quarterly review cycle for member, client and/or account records.
- Help support the development of standardized services and practices across all assigned programs.
- Prepare and monitor, in partnership with the program staff, corrective action plans developed internally and externally.
- Perform program audits as assigned and assist programs with pre-audit preparations.
- Demonstrate knowledge, awareness of AHS product lines and equipment per MCO authorization requirements.
- May assist on special projects connected to staffing, compliance, budgeting, and professional development.
- Communicate and report AHS performance outcomes, indicators, and target goals.
- Perform all duties within contract, state and federal regulations, company policy, and regulatory agency standards.
- May be required to drive vehicles, be insurable with our auto insurance provider, and complete company vehicle training.
A high school diploma and at least 3 years of Medicaid claims experience preferred.