Compliance Specialist

SERVICE MANAGEMENT GROUP INC•Minnetonka, MN

About The Position

The Compliance Specialist will collaborate closely with the Chief legal Officer and Operations Director, to assist in establishing and maintaining an effective compliance program, policies, and procedures for Homesura. This involves staying informed about all aspects of pertinent compliance best practices, encompassing local, state, and federal statutes and regulations relevant to community-based home healthcare organizations. Additionally, the Compliance Specialist is expected to research and communicate specific changes and emerging best practices to leadership, when appropriate and necessary. Homesura Offers: Work/Life Flexibility Professional Development Opportunities. Generous Paid Time Off options Free Mental Health/Wellbeing Program Health and Dental Insurance for full time employees HSA + FSA for full time employees Retirement Plan Company Paid Disability & Life Insurance for full time employees

Requirements

Minimum two-year degree and/or ten years of experience in a human services or healthcare related field. Bachelor’s degree preferred.
2+ years' experience in Medicaid program (reimbursement, billing, etc.) required.
2+ years' experience working in fraud prevention and detection is strongly preferred.
Understanding of state, federal, and local statutes pertinent to community-based home healthcare organizations. Ability to interpret and communicate applicable legislation or regulations
Must have deductive reasoning skills, to apply general rules to specific problems to produce answers that make sense.
Must demonstrate skills to assist the with designing, implementing, and maintaining an effective compliance program, policies, and procedures.
Excellent organizational, problem-solving, communication, creative, critical thinking, and interpersonal skills.
Highly effective verbal and written skills, and the demonstrated ability to communicate challenging concepts both in-person, over the phone, and in electronic communication
Ability to analyze data to inform operational decisions or activities.
Maintain a professional demeanor at all times, ensuring strict confidentiality in all compliance matters including HIPPA or other confidentiality requirements.
Must pass a background study with the Minnesota Department of Human Services and possess a valid driver’s license, clean driving record and reliable transportation to use for work driving purposes
Working knowledge of Accra’s IT/Business systems and demonstrated proficiency in the use of Microsoft Office tools
Position requires strong ability to working independently, with attention to detail and ability to meet strict deadlines.
Must be proficient in all MS Outlook computer applications (Word, Outlook Excel, TEAMS.)
Required to pass a background study with the Minnesota Department of Human Services.

Responsibilities

Ensure accuracy and compliance in all Homesura compliance activities.
Assist divisions to ensure in following agency regulations, contracting, licensing, and credentialing.
Assist with compliance audits, corrective actions, and documented follow-up on any violations.
Assist with compliance program, accurate and timely maintenance of records and report filing.
Follow-though and proactively communicate about timelines, deadlines, and ensure Homesura and divisions meet compliance requirements.
Work collaboratively with Homesura and division personnel to ensure accurate and timely billing activities are done within legal guidelines.
Accurately maintain all Insurance/Payor annual requirements as related to the contracts, personnel licensure and credentialing.
Monitor and maintain contracts and ensure appropriate persons involved in updating contracts as required.
Responsible for all record requests – insurance, fraud, billing records, etc.
Support all Homesura divisions in education, training, policy development in necessary compliance areas.
Create and maintain accurate reports and compliance recordkeeping as required.
All other duties as assigned.