Junior Billing Compliance Coordinator

The Jewish Board•New York, NY

About The Position

The Corporate Compliance department supports the agency in maintaining compliance across its operations. It promotes a culture of compliance, prevents and detects fraud, waste, and abuse, and educates staff about their rights to report suspected non-compliance. The Junior Billing Compliance Coordinator supports the Corporate Compliance Program within one or more agency divisions to help ensure billing requirements are met. Working under the Director of Corporate Compliance for billing, the coordinator works with senior compliance specialists, management, and staff to support compliance with applicable billing laws and regulations, agency policies and procedures, and the code of conduct, responding to matters in a timely manner. The position conducts internal billing and claims audits; tracks regulatory updates and audit findings; identifies areas of potential exposure and risk; and helps develop and implement corrective action plans. It may involve investigations into fraud, waste, and abuse of public funds, responses to alleged violations and complaints, regulatory projects, staff training, and agency accreditation preparation. The role works collaboratively with program staff and support departments and contributes to an environment that fosters engagement, equity, inclusion, and belonging. The work is performed in an office or comparable education, rehabilitation, industrial, workshop, or health-related environment, with noise and hazards typical of those settings. The role requires reading documents and computer information for analytical purposes and limited manual dexterity and hand-eye coordination.

Requirements

Bachelor of Arts or Bachelor of Science degree.
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.
Strong ability to independently research, read, and accurately interpret complex state and federal regulations and guidance, and apply them to auditing activities.
Strong engagement skills and ability to model effective engagement in interactions.
Strong verbal and written communication skills, including communicating and interpreting policies and procedures in corporate compliance.
Strong analytical skills to identify citation trends and potential risks.
Ability to work in a fast-paced environment, manage multiple varied tasks, and maintain attention to detail, productivity, and quality.
Ability to maintain performance while working independently and collaboratively with internal and external teams.
Strong interpersonal skills and ability to engage staff at all levels of responsibility.
Project management and organizational skills and ability to work independently.
Experience in a not-for-profit or social-service setting.
Excellent organizational, time-management, written communication, and verbal communication skills.
Proven analytical and problem-solving skills.
Ability to attend agency meetings held during business hours.
Knowledge of personal computers, standard software, and database management.
Intermediate proficiency with 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; lead meetings and task forces; respond to sensitive or confidential inquiries and complaints; present information effectively; and maintain confidentiality.
Ability to read documents and computer information for analytical purposes; limited manual dexterity and hand-eye coordination.

Nice To Haves

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

Responsibilities

Remain up to date on regulatory and guidance requirements.
Conduct internal billing and claims audits across the agency.
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 with agency requirements, including requirements reflected in audits conducted by OMIG, CMS, third-party vendors, and MMCOs.
Maintain the audit record hub for a designated division of service, including findings and performance improvement plans.
Identify potential areas of exposure and risk.
Assist in developing corrective action plans to resolve risks and ensure their implementation.
Lead or participate in investigations involving fraud, waste, and abuse of public funds.
Respond to alleged violations of rules, regulations, and policies; evaluate complaints and recommend inquiries to a supervisor as appropriate.
Collaborate with program staff and support departments to address and mitigate identified exposure.
Coordinate regulatory-mandated projects and support the use of regulatory systems, organizing training activities as needed.
Conduct staff training on compliance requirements, regulations, and issues, including facilitating the agency's compliance component.
Participate in agency-wide accreditation preparation and the accreditation survey.
Support an environment that fosters team-member engagement, equity, inclusion, and belonging.
Establish clear objectives tied to department or organizational strategic goals.
Complete other duties as needed and special projects assigned by agency leadership.