Medical Compliance Specialist
6 days ago
We are seeking a highly detail-oriented and organized Medical Compliance Specialist to join our team at the KHEIR Center in Los Angeles. The ideal candidate will have excellent communication skills, a commitment to upholding the highest standards of ethical conduct, and a strong understanding of healthcare laws and regulations.
The Medical Compliance Specialist will be responsible for managing the credentialing process for healthcare providers, ensuring compliance with accreditation standards, regulatory requirements, and organizational policies. This includes collecting, reviewing, and verifying credentials, conducting primary source verification, maintaining internal provider grids, and ensuring enrollment in government programs.
Key Responsibilities:
- Collect, review, and verify credentials of healthcare providers
- Conduct primary source verification of credentials
- Maintain internal provider grid to ensure accuracy
- Ensure enrollment in Medi-Cal, Medicare, and other government programs
- Complete revalidation requests issued by government payers
- Maintain accurate and up-to-date records in credentialing databases
As a Medical Compliance Specialist, you will serve as a point of contact for providers regarding credentialing inquiries and issues. You will also communicate credentialing requirements and processes effectively to new and existing staff, assist in training and onboarding of new credentialing staff, and provide support in developing and implementing credentialing policies and procedures.
You will work closely with the Compliance and Credentialing teams to maintain current knowledge of relevant compliance requirements, clinic operations, and managed care programs. You will also monitor and track compliance indicators to ensure the clinic's adherence to standards.
This is an exciting opportunity to join a dynamic organization that provides critical in-language healthcare and human services support to underserved residents in the greater Los Angeles area. As a Medical Compliance Specialist, you will play a crucial role in ensuring the integrity and quality of our services.
**Estimated Salary:** $65,000 - $80,000 per year based on experience and qualifications.
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