Compliance Specialist - Fulltime - In Office

HCR Home Care•Rochester, NY

21d•$22 - $27•Onsite

About The Position

Responsible for all activities related to order compliance and management of provider credentials and demographics in system(s); this position assures optimal regulatory compliance and contributes to positive cash flow. This job description reflects management’s assignment of essential functions; and nothing in this herein restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

Requirements

Associates degree required; in lieu of degree, at least 2 years’ experience in Medical Records, or experience in a healthcare setting with a full understanding of a Medical Records Specialist role.
Medical knowledge/ terminology a plus.
Demonstrated ability to apply critical thinking to tasks.
Outstanding customer service and communication skills.

Responsibilities

Monitor orders which are in the Mosia escalations folder and perform necessary follow-up.
Provide education and support to Medical Records staff as it pertains to Mosia and indexing, to ensure timely and appropriate follow-up.
Monitor reports and Mosia tracking features to assure goals of Orders Lifecycle are met.
Perform follow up related to timely receipt of unsigned Orders including: Calls to physician offices and communication with Clinical team members/ managers to resolve issues as needed.
Elevate unresolved issues to Team Leader or Manager.
Document actions in system to support compliance with internal policies and regulatory guidelines.
Verify credentials including: licensing, NPI, PECOS, OPRA, and OMIG/OIG/GSA sanctions, for new Providers. and update system accordingly.
Monitor and maintain Add/Change Physician workflow, including: provider additions and changes, updating provider demographics, delivery methods, as well as changes in corresponding orders as needed.
Develop working relationships with Physician offices.
Mail, track, and file signature attestation letters for new MDs.
Communicate regularly with manager to ensure maximum compliance with orders.
Other duties as assigned.