Compliance Specialist Jobs

About The Position

Requirements

• Bachelor’s degree in public or healthcare administration, human services, compliance or a related field with at least two (2) years experience OR an Associates degree/certifications/experience with a minimum of (5) years in healthcare compliance, auditing, quality assurance or regulatory work

Nice To Haves

• Master’s degree
• Compliance certification (e.g., CCEP, CHC, CHPC)
• Experience working with OMH, OCFS or OMIG environments
• Experience with NYS Medicaid billing

Responsibilities

• Supports the ongoing maintenance of the organization’s Corporate Compliance Program.
• Assists in ensuring organizational compliance with Medicaid, OMH, OCFS, and other applicable federal and state regulatory requirements.
• Participates in organizational compliance and risk assessment activities to identify areas of potential vulnerability and recommends mitigation strategies.
• Assists with the development, review, and revision of compliance-related policies and procedures, internal controls, and assessments and audit tools.
• Serves as a key participant on the organization’s compliance committee, and other quality improvement committees as appropriate.
• Conducts billing, claims, and documentation audits to assess compliance with Medicaid and payer requirements, organizational policies, and regulatory standards.
• Monitors audit findings, track corrective action plans, and support follow-up activities to ensure resolution of identified issues.
• Assists with internal and external compliance reviews, audits, investigations, and regulatory inquiries.
• Delivers compliance-related training and education materials for employees, leadership, contractors, and other stakeholders.
• Promotes awareness of compliance expectations, reporting obligations, and ethical standards throughout the organization.
• Supports the intake, tracking, documentation, and follow-up of compliance concerns, complaints, and reports.
• Assists the Director of QAI and Compliance in compliance-related investigations.

Benefits

• medical
• vision
• dental
• life insurance
• 403(b)
• tuition reimbursement
• paid time off
• vacation
• personal days
• holidays
• sick days