Medicare Compliance Specialist

1 week ago

Albany, New York, United States CDPHP Full time

About CDPHP: Founded in 1984, CDPHP is a not-for-profit health plan dedicated to providing high-quality, affordable health insurance to members across New York. Our mission is grounded in core values that emphasize compassion, community, and innovation. We pride ourselves on fostering a culture of belonging and actively promoting diversity, equity, and inclusion within our workforce.

Position Overview: The Medicare Compliance Coordinator plays a crucial role in supporting the Medicare Compliance Officer in managing the Medicare compliance program. This includes overseeing and executing various internal and external audits and monitoring initiatives. The ideal candidate will demonstrate the ability to work autonomously and manage time effectively to fulfill all project requirements.

Key Responsibilities:

  • Serve as a primary resource for CDPHP staff regarding compliance inquiries related to audit updates and activities.
  • Review and analyze regulatory changes and communications from CMS concerning audit protocols.
  • Draft written summaries and impact assessments of regulatory changes as directed by the Medicare Compliance Officer.

Qualifications:

  • Bachelor's degree or four years of equivalent experience is required.
  • Preferred degrees include Computer Science or Information Systems.
  • Prior auditing experience is advantageous.
  • Experience working with the Medicare population is essential.
  • 1-2 years of experience in health insurance program management or administration is preferred.
  • Familiarity with managed care or indemnity products is required.
  • Strong verbal and written communication skills are necessary.
  • Ability to present information effectively in public speaking scenarios.
  • Collaboration and teamwork skills are essential.
  • Proven ability to research, analyze, and resolve issues with minimal supervision.
  • Proficiency in MS Word and Excel is required; experience with project management software or Access is preferred.

Compensation and Benefits: CDPHP offers competitive salary ranges designed to promote professional and financial growth. Compensation is based on individual factors such as experience and qualifications. In addition to salary, employees may be eligible for incentive payments based on performance. Our comprehensive benefits package includes award-winning health care coverage, generous paid time off, employee assistance programs, and a flexible work environment.

Diversity and Inclusion: As an Equal Opportunity / Affirmative Action Employer, CDPHP is committed to a diverse workforce and does not discriminate based on any protected status. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex, sexual orientation, gender identity, age, national origin, marital status, disability, or any other characteristic protected by law.

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