Regulatory Compliance Specialist I

Anovorx Group LLC•Memphis, TN

32d

About The Position

The Regulatory Compliance Specialist will support, monitor and audit adherence to pharmacy, privacy and billing regulations, standards, policies and procedures, obtain and maintain Anovo’s licenses, permits and billing privileges, assist in identification of current laws and regulations applicable to Anovo, and support Anovo’s HIPAA program. The below is intended to describe the general content of and requirements for the performance of this job and is not to be construed as an exhaustive statement of essential functions, responsibilities, or requirements.

Responsibilities

Respond timely to routine commercial and governmental payer audits, prepare dispute and appeal documentation as needed, and maintain required documentation and logs.
Obtain, maintain and timely renew all pharmacy, wholesale and 3PL licenses, DEA permits, controlled substance permits, and keep tracking sheets and license folders current and complete.
Prepare and submit change of ownership, pharmacist-in-charge, officer/director and location opening or closings, in accordance with applicable laws and research those laws to assure compliance; and communicate as needed and maintain good relationships with Board of Pharmacy and Medicaid personnel; and maintain logs and documentation to record the filings.
Obtain, maintain and renew all Medicaid and Medicare numbers including timely submission of revalidations and information changes; communicate as needed and maintain good relationships with Medicaid and Medicare personnel; and regularly update Medicaid, NCPDP and NPPES portals and keep tracking sheets and documentation in folders up to date.
Assist VP Regulatory Compliance and Licensing with conduct of internal compliance audits, inclusive of monthly prescriber license verification and Privacy and security audits and monitoring.
Assist VP Regulatory Compliance and Licensing with researching regulatory laws and requirements affecting Anovo, tracking regulatory changes that have organizational impact, and ensuring compliance with applicable state and federal laws and regulations, including without limitation those promulgated by state Boards of Pharmacy, CMS, OIG, HHS, DEA, and other applicable governing bodies.
Act as primary preparer and provider to Anovo Departments of credentialing materials, and maintain credentialing materials and spreadsheets in readily available usable state.
Alert VP Regulatory Compliance and Licensing to any identified deficiencies or issues (i.e. issues with renewals, lack of a needed license, HIPPA violations, payer or provider unrest).
Assist VP Regulatory Compliance and Licensing with Anovo’s HIPAA program, including maintenance of the HIPAA Incident logs and files, and monitoring for compliance with Anovo’s HIPAA program
Format documents and prepare excel and word spreadsheets, power points, organization charts and Visio charts as requested or needed.
Special projects as assigned.
Focus on resolving issues, and providing polite, professional and appropriate responses to Anovo staff and external customers.
Regular and reliable attendance expected.
Other work-related duties as assigned by supervisor/manager.