Audit and Regulatory Specialist

Medical Service Company•Cleveland, OH

1d•Hybrid

About The Position

At MSC, we are dedicated to enhancing patient comfort and quality of life with over 75 years of experience and accredited by the Accreditation Commission for Health Care (ACHC). MSC is a 13 -Time recipient of the prestigious NorthCoast 99 Award as a Top Workplace to work! MSC is a two-time recipient of the prestigious National HME Excellence Award for Best Home Medical Equipment company in the US. In addition, MSC is very proud to announce its debut on the Inc. 5000 list in 2024, marking a significant milestone in our company's growth and success! Join Our Team! We are excited to announce that we are hiring for a full-time hybrid position . Work in our office location on Tuesdays, Wednesdays, and Thursdays , and enjoy the flexibility of remote work on other days. Benefits included! Apply today to become a part of our dynamic team! Competitive Pay, C ommissions, Auto & Mileage Reimbursement Advancement Opportunities Medical, Dental & Vision Insurance HSA Account w/Company Contribution Pet Insurance Company provided Life and AD&D insurance Short-Term and Long-Term Disability Tuition Reimbursement Program Employee Assistance Program (EAP) Employee Referral Bonus Program Social Recognition Program Employee Engagement Opportunities CALM App 401k (with a matching program) / Roth IRA Company Discounts Payactiv/On-Demand Pay Paid vacation, Sick Days, YOU (Mental Health) Days and Holidays General: Under the direction of the Director, Regulatory, Compliance and Risk, Ensures compliance with regulations and controls by examining and analyzing records, reports, operating practices, and documentation; and recommending opportunities to strengthen the internal control structure. Verifies assets and liabilities by comparing items to documentation

Requirements

Education: Graduate of an accredited high school or GED equivalence.
Experience/Knowledge/Skills/Physical Requirements: DME Industry experience, preferably in a regulatory capacity
Analytical skills refer to your ability to break down a problem, gather facts, and find a logical solution.
Demonstrated ability to use Smartsheet, Microsoft Excel, Word and PowerPoint
Familiarity with Medicare, State Medicaid and commercial insurance billing and reimbursements as related to DME
Excellent verbal and written communication and customer relation skills.
Excellent interpersonal and organizational skills (a team player).

Responsibilities

Responsible for replying to and tracking of external audit activity for a variety of payers including Medicare, Medicaid and commercial payers
Appeals of denied audits
Conducts internal audits to assure compliance with policy changes driven by Regulatory Requirements
Developing and providing employee training on compliance policies, practices, and reporting systems
Identifying, investigating, and reporting compliance issues, irregularities, and violations
Assist with maintenance of branch records including all regulatory requirements such as licenses, etc.
Tracking and responding to patient grievances
Other Projects as required