Compliance Specialist

4 weeks ago

St Petersburg, United States GA Foods Full time

Great opportunity for a high-caliber self-starter to join our growing team Willing to train the right individual who is self-directed, possesses strong administrative, organizational, computer and communication skills, and eagerness to learn.

Essential Duties:

  • Prepares and completes online all state Medicaid program enrollments and revalidations.
  • Prepares and completes all Managed Care Contract credentialing and re-credentialing forms and applications.
  • Maintains and conducts monthly exclusion verifications and associated reporting. Performs follow up with management on any false positives or hits.
  • Assists and Prepares all audits and audit responses.
  • Ensures all state licensure, permits, and annual reports are filed and maintained in accordance with the regulations and are timely renewed. Updates and maintains Compliance Tracking system in the ERP.
  • Point for input and roll out of Compliance and Risk Management training modules, updating enrollee information, conduct compliance audits and set up and pull reporting from the Company's LMS system. Follow up with management to ensure employee training is completed timely, whether new hire or annual mandatory training, to meet regulatory requirements.
  • Assembles, copies, files, scans various documents, including monitoring packets, contract documents, litigation documents, audit responses and request for proposals/bids.
  • Ensures required State Medicaid fingerprinting database systems are maintained up-to-date, including input of employment information into online systems, and updating tracking documents as required
  • Maintains and uploads e-files in Document Repository, Sharepoint, other.
  • Participates in development of policies and SOP's.
  • Works on special projects as directed.
  • Demonstrates commitment to providing outstanding customer service in a manner that is reflective of GA's mission, vision, values, organizational context, code of conduct, and customer service standards.
  • Identifies opportunities for continuous improvement, develops related plans of action, and implements process and documentation improvements.
  • Committed to continuing professional development.
  • Participates fully as a member of the Contracts and Compliance department, including participating in culture development and building a strong team for delivering GA's mission.
  • Performs other duties assigned by management.

Education/Experience:

  • Minimum Associates Degree in Business Administration or related field preferred, or equivalent combination of education/experience.
  • Proficient in use of the Microsoft Office suite of products; Word, Excel, and Outlook, Teams, Sharepoint a plus.
  • Familiar with Health Care Compliance and/or Training in healthcare regulations a plus.
  • Familiar with contracting and legal documentation a plus.
  • Demonstrates strong proficiency with MS Word, Excel and Powerpoint.
  • Active Notary (or able to and must be qualified to obtain post-hire)

Work Environment:

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. This is largely a desk-bound role with typical office noise; however, frequent movement throughout the office is required. Frequent sitting, standing, and walking are daily activities. Some bending and filing may be required (

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