Junior Billing Compliance Coordinator

The Jewish Board•New York, NY

8d•$66,300

About The Position

The Corporate Compliance department supports the agency in maintaining compliance across its operations by promoting a culture of compliance, preventing and detecting fraud, waste, and abuse, and educating staff about reporting suspected non-compliance. The Junior Billing Compliance Auditor supports The Corporate Compliance Program within one or more agency service divisions, helping ensure billing compliance requirements are met. Reporting to the Director of Corporate Compliance for billing, the role coordinates with senior compliance specialists, management, and staff to promote compliance with applicable billing laws and regulations, agency policies and procedures, and the code of conduct, and to respond to matters in a timely manner. The position conducts agency-wide billing and claims audits; tracks regulatory updates and audit findings; identifies risk and exposure; and supports corrective action planning and implementation. It also contributes to investigations, staff training, regulatory projects, Compliance Review Committee meetings, and agency accreditation preparation. The role requires researching and interpreting complex regulatory materials, strong communication and analytical skills, and the ability to work independently and collaboratively. The work environment is office-like, with noise and hazards consistent with common office, education, rehabilitation, industrial, workshop, or health-related environments. The position involves reading documents and limited manual dexterity and hand-eye coordination.

Requirements

Bachelor’s degree (BA/BS) required.
Experience in a related field, such as behavioral health, CASAC, public health, public administration, or social work.
Experience with state regulators, including OCFS, OMH, OPWDD, OMIG, OASAS, DOHMH, NYS DOH, and ACS.
Experience in a not-for-profit or social service setting.
Strong ability to independently research, read, and accurately interpret complex state and federal regulations and guidance, and apply them to auditing activities.
Strong interpersonal, engagement, verbal, and written communication skills, including the ability to interpret and implement policies and procedures.
Strong analytical and problem-solving skills, including the ability to identify citation trends and potential risks.
Project management, organizational, and time-management skills; ability to work independently and manage varied tasks while maintaining attention to detail, productivity, and quality.
Ability to maintain quality performance while working autonomously and collaboratively with internal and external teams.
Ability to attend agency meetings held during business hours.
Knowledge of personal computers, standard software, and database management.
Intermediate proficiency in Microsoft Office Suite and ability to adapt quickly to agency computer applications.
Ability to articulate the agency’s philosophy, mission, and goals to varied audiences; interview managers, employees, consumers, and families; write reports, correspondence, and procedures; and lead meetings or task forces involving multiple organizational levels.
Ability to respond to inquiries or complaints, including sensitive and confidential matters, from relevant stakeholders and in a variety of circumstances.
Ability to present information effectively in verbal and written formats and maintain confidentiality.
Ability to read documents for analytical purposes and perform limited manual dexterity and hand-eye coordination tasks.

Nice To Haves

MS, MA, MBA, MPA, LCSW, or LMSW degree.
One year of auditing experience.
Prior experience interpreting regulations and/or developing and implementing policies.
Certification in Lean Six Sigma.

Responsibilities

Remain up-to-date and knowledgeable about regulatory and guidance requirements.
Conduct internal billing and claims audits agency-wide.
Participate in and assist with coordinating Compliance Review Committee meetings.
Maintain a division-wide matrix of regulatory updates.
Independently review departmental procedures, policies, and practices for compliance, including requirements reflected in billing audits conducted by OMIG, CMS, third-party vendors, and MMCOs.
Maintain the audit recording hub, including audit findings and performance improvement plans within a designated division of service.
Identify potential exposure and risk; assist in developing corrective action plans and ensure their implementation.
Lead or participate in investigations of fraud, waste, and abuse of public funds.
Respond to alleged violations, evaluate complaints, and recommend inquiries to a supervisor when appropriate.
Collaborate with program staff and support departments to address and mitigate identified exposure.
Coordinate regulatory-mandated projects and support regulatory systems, organizing training activities as needed.
Conduct staff training on compliance needs, regulations, and issues, including facilitating the agency’s compliance component.
Participate in agency-wide accreditation preparation and the accreditation survey.
Foster team member engagement, equity, inclusion, and belonging, and establish objectives tied to department or organizational strategic goals.
Complete other duties as needed and special projects assigned by agency leadership.