Compliance Program Coordinator
7 days ago
MedPOINT Management is committed to upholding the highest standards of ethics and compliance in the healthcare industry. As a Compliance Delegation Coordinator, you will play a vital role in ensuring our organization's culture maintains integrity, reduces the risk of fraud and abuse, and enhances the quality of services and care to patients.
Key Responsibilities
- Prepare and submit audit universe reports to external auditors from health plans.
- Review and validate audit documents to external auditors from health plans.
- Assist with internal quality reviews of department processes.
- Support Health Plan Oversight Audits/Ad Hoc Requests.
- Support internal quality review of the PNO process.
- Participate in Regular and Ad Hoc Compliance meetings.
- Back up personnel for communicating reminders to business owners for upcoming external audits for universe selections, pre-audit materials, and approaching corrective action deadlines.
- Interface with various departments for compliance-related activities as needed.
- Miscellaneous projects as assigned to support Regulatory Affairs & Compliance department.
- Adhere to MedPOINT Management's core values: Accountability, Community, Celebration, Integrity, Innovation & Collaboration.
Requirements
- High School diploma or equivalent.
- Experience in an HMO or in a Managed Care setting preferred.
Preferred Skills
- Advanced knowledge of Microsoft Applications, specifically Excel.
- Knowledge of EZ-CAP® is a plus.
- Knowledge of Customer Service, Claims, or Referral processing in a healthcare setting.
- Managed Care, and State and Federal regulations a plus.
- Professional demeanor, excellent communication, and interpersonal skills.
- Strong organization skills and knowledge of managed care environment.
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