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Medicare Compliance Specialist
2 months ago
About Capital District Physicians' Health Plan (CDPHP)
CDPHP is a not-for-profit health insurance provider established in 1984, dedicated to delivering high-quality, affordable health coverage to members across New York. Our mission is grounded in compassion, innovation, and a commitment to community well-being.
Position Overview
The Medicare Compliance Coordinator plays a crucial role in supporting the Medicare Compliance Officer in managing the Medicare compliance framework. This position involves coordinating and executing various internal and external audits and monitoring initiatives. The ideal candidate will demonstrate the ability to work autonomously and efficiently manage time to fulfill all audit and monitoring obligations.
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 concerning CMS audit protocols.
- Draft written summaries and impact assessments of regulatory changes as directed by the Medicare Compliance Officer.
Qualifications
- A Bachelor's degree or a minimum of four years of relevant 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 settings.
- Collaborative team player with problem-solving capabilities.
- Proficiency in MS Word and Excel is required; experience with project management software or Access is a plus.
Compensation and Benefits
CDPHP offers competitive salary ranges with opportunities for professional and financial advancement. Compensation is determined based on unique factors such as experience, qualifications, and skills. In addition to base salary, employees may qualify for incentive payments based on individual and company performance, with some roles eligible for overtime pay.
Our comprehensive total rewards package includes award-winning health care coverage, health care dollars, generous paid time off, employee assistance programs, and a flexible work environment. For more information on employee benefits, please refer to our resources.
Diversity and Inclusion
As an Equal Opportunity / Affirmative Action Employer, CDPHP is committed to fostering a diverse and inclusive workplace. We do not discriminate in employment practices based on race, color, creed, religion, sex, sexual orientation, gender identity, age, national origin, marital status, disability, or any other characteristic protected by law.
