Job Description

Key Responsibilities :

• Evaluate child/youth’s case for compliance to applicable regulations.
• Clearly communicate evaluation requirements and follow up.
• Evaluate documentation against applicable regulations.
• Collect data and documentation to support compliance findings.
• Utilize technology to convert hard copy documentation to electronic and submit via secure file transfer.
• Record, summarize, and communicate compliance findings
• Assist in determining trends in non-compliance.
• Make appropriate and timely recommendations to project management.
• Assist with the ongoing operationalization of project’s processes and procedures.
• Assist with all internal and external reporting.
• Build and maintain relationships with stakeholders to provide a high level of customer service.
• Traveling to provider sites to perform case reviews.

Required Qualifications:

• Bachelor’s degree in public health, healthcare management, psychology, human services, or related field.
• A minimum of 2 years of A minimum of 2 years of experience as a Healthcare Compliance Analyst, Auditor, Care Manager, or Medicaid Provider, in a role responsible for conducting oversight, compliance audits or chart reviews, or ensuring quality of care.
• An equivalent combination of advanced education, training, and experience will be considered.
• Experience with Medicaid fee-for-service and/or Managed Care billing.
• Proficiency in MS Excel, MS Word, MS Outlook, MS Visio, MS PowerPoint and MS SharePoint.

Preferred/Desired Qualifications:

• Extensive knowledge of, and experience with, Home and Community-Based Services Waiver programs, either as a provider or compliance officer.
• Experience with Medicaid billing, including the use of various Electronic Health Records (EHR) systems.
• Experience with compliance audits or chart reviews.
• Ability to work with and relate to staff and demonstrate active listening skills.
• Process oriented and results-driven work strategy.
• Ability to foster teamwork with all levels of management and staff.
• Ability to work well independently and within a team.
• Exceptional customer service relationship techniques, including superior verbal and written communication skills.
• Excellent accuracy and attention to detail.
• Experience in meeting deadlines and adhering to strict standards of performance.

GENESYS Consulting Services, Inc. is proud to be an equal-opportunity employer.

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