Sr. Compliance Specialist

FreedomCare•New York, NY

9h•$26 - $30

About The Position

FreedomCare is a healthcare company dedicated to revolutionizing the home care industry since 2016, supporting patients across the U.S. by enabling them to choose a caregiver for home-based care. The company operates with core values: Here For You, Own It, Do the Right Thing, and Be Positive. They are seeking a Sr. Compliance Specialist to join their Compliance team. This role will support the department in reviewing legal documents, conducting and responding to internal/external audits, and investigating Fraud, Waste & Abuse claims, ensuring the department maintains regulatory requirements.

Requirements

Bachelor’s degree and a minimum of 3 years of experience in the healthcare industry or Associate degree and a minimum of 5 years experience in the healthcare industry
Extensive knowledge of Medicaid regulations
Experience with Exclusion screening and background checks

Nice To Haves

Extensive knowledge of Billing and Coding preferred
Ability to exercise good judgment in using knowledge of best practices, regulations, and knowledge of business processes
Ability to work with limited supervision on complex matters; self-starter and takes initiative
Demonstrated ability to be detail-oriented and thorough
Reliable and detail oriented.
Adept at multi-tasking
Prior experience with internal and external audits

Responsibilities

Conducting and responding to internal and external audits for all jurisdictions
Assisting with conflict reporting and collaborating with our finance department to resolve conflicts
Subpoena of Medical records and general record requests
Investigating fraud, waste & abuse claims
Making suggestions on next steps of FWA claims
Be a resource for escalated concerns for all active states
Quality assurance review
All other compliance duties as assigned