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Audit Compliance Supervisor
4 months ago
Job Description
Audit Compliance Supervisor
525178
PHOENIX
REMOTE OPTIONS
AHCCCS
Full-time
AHCCCS
Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Courage, Teamwork
The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, is driven by its mission to deliver comprehensive, cost-effective health care to Arizonans in need. AHCCCS is a nationally acclaimed model among Medicaid programs and a recipient of multiple awards for excellence in workplace effectiveness and flexibility.
AHCCCS employees are passionate about their work, committed to high performance, and dedicated to serving the citizens of Arizona. Among government agencies, AHCCCS is recognized for high employee engagement and satisfaction, supportive leadership, and flexible work environments, including remote work opportunities. With career paths for seasoned professionals in a variety of fields, entry-level positions, and internship opportunities, AHCCCS offers meaningful career opportunities in a competitive industry.
Come join our dynamic and dedicated team.
Audit Compliance Supervisor
Division of Fee For Service Management (DFSM)
**Job Location**:
**Address**: 801 E. Jefferson Street, Phoenix, AZ 85034
**Posting Details**:
**Salary**: $73,000 - $78,000
**Grade**: 22
**Closing Date**: Open Until Filled
This position has the potential to work from a Virtual Office (VO) setting or may telecommute based on the needs of the unit and at the discretion of leadership.
Must reside in the State of Arizona.
**Job Summary**:
The Division of Fee For Service Management (DFSM) is looking for a highly motivated individual to join our team as an Audit Compliance Supervisor. Under the direction of the Audit and Prepayment Manager, this position is responsible for the oversight of a variety of audit types including but not limited to Adult Dental, Behavioral Health, Global OB, Inpatient, Outpatient Clinic, Non-emergency, Transportation, Podiatry, etc. This position has the potential of conducting on-site reviews, in support of overall strategic goals of DFSM and AHCCCS leadership.
The State of Arizona strives for a work culture that affords employees flexibility, autonomy, and trust. Across our many agencies, boards, and commissions, many State employees participate in the State’s Remote Work Program and are able to work remotely in their homes, in offices, and in hoteling spaces. All work, including remote work, should be performed within Arizona unless an exception is properly authorized in advance.
Major duties and responsibilities include, but are not limited to:
Overseeing sample audits, reviewing provider records checking compliance with federal and state rules, regulations, and AHCCCS policies and procedures, and identifying recoupment amounts. Oversight of audit staff and development of direct reports.
Reviews and analyzes regulations and laws applicable to the AHCCCS programs and reports findings to DFSM Leadership.
Develops procedures and methods to enhancement the program's records submission process. Participate in the development and delivery of trainings related to the improvement of the audit program and related areas.
Participate in, in-person provider reviews by conducting provider on-site visits with the DFSM Quality of Care units as needed. Participate in internal and external meetings as requested to collaborate with others and ensure full understanding of team and departmental work flows.
Process the pre-payment reviewed claims. Evaluate and monitor trends in, claims pre-payment and under utilization, data outliers and similar audit related irregularities, in order to provide consistent oversight and technical assistance to the audit unit.
Facilitate team meetings, huddle boards, monthly Audit Committee and similar meetings. Meet with Claims' Leadership and/or other leaders to discuss overall unit objectives and develop a fluid management plan.
**Knowledge, Skills & Abilities (KSAs)**:
**Knowledge of**:
Principles and practices of supervision and staff development.
Principle and practices of auditing.
AHCCCS, ALTCS, Medicaid and Medicare Regulations.
Medicaid and Medicare Federal Regulations, State Statute, Rules, and Policies applicable to AHCCCS programs.
Advanced knowledge of the behavioral health service delivery system and the needs of children and the needs of individuals designated as SMI.
Principles of behavioral health management and assessment.
Fundamental of IHS/638 claims processing and billing.
AHCCCS Information Management System Prepaid Medical Management Information System (PMMIS).
**Skills in**:
Project management of multiple projects.
Analyze and effectively recommend resolution to provider issues.
Excellent verbal/written communication skill.
Organizational skills to coordinate, monitor and report on multiple cases simultaneously.
Analytical skills to identify and correlate specific patterns, i
