Services for the Underserved

Compliance Specialist

Job Location US-NY-New York
Category
Quality Assurance
Type
Regular Full-Time

Position Overview

As a leading provider of residential and support services to individuals with special needs, Services for the UnderServed provides the resources you need to build on your experience amidst our culture of team support. Ongoing training and attention to your development help to ensure your success. Your achievements and leadership are rewarded by advancement opportunities. Our commitment to continuous quality improvement impacts the lives of our clients and communities while contributing to the development of our employees.

 

The Compliance Specialist will conduct documentation reviews to ensure compliance with Medicaid/ Medicare billing guidelines as well as specific policies of all insurance carriers.

 

Responsibilities:

  • Responsible for reviewing documentation for billing for ACT Teams, Licensed OMH Housing, Care Coordination and Clubhouse to ensure compliance with billing/coding requirements of Office of Medicaid Inspector General, OMH and other regulatory agencies.
  • Review and audit the quality of clinical case documentation and services.
  • Conduct documentation training with staff regarding billing requirements for services provided.
  • Perform retrospective, concurrent, and prospective audits to ensure all CPT codes billed are supported by documentation in the medical record and are compliant with State and Federal regulations.
  • Ensure compliance with HIPAA and other regulatory requirements for responsible areas.
  • Review service plans to assure goals are realistic, reflect consumer input, and respond to consumer strengths and needs.
  • Responsible for conducting unannounced visits to programs sites to perform observations/fire drills.

Benefits Overview: We offer attractive compensation with comprehensive benefits including: Medical/Dental/Prescription/Vision/Life Insurance;403(b); Credit Union; FSAs; Short-and-Long-Term Disability; Transportation Plan; Generous Paid Vacations and Holidays

Qualifications

  • Bachelor’s Degree required however Master’s Degree preferred.
  • Minimum 2 years of experience as a quality assurance staff member within a Human Services organization.

  • Experience conducting documentation reviews to ensure compliance with regulatory requirements.

  • Experience working with consumers or in programs which provided services to consumers with Developmental Disabilities (DD)/ Behavioral Health (BH)/ OASAS/ Veterans/ Shelter Services and / or People Living with AIDS (PLWA).

  • Minimum 1 year of experience in intermediate levels of MS Word, Excel, Outlook.

  • Flexibility to work on special projects after regular office hours and on weekends and ability to travel throughout the boroughs.

 

SUS IS AN EQUAL OPPORTUNITY EMPLOYER

Company Overview

Join a team of employees who cares about the wellbeing of others. We believe in fostering a culture built on our core values: respect, integrity, support, maximizing individual potential and continuous quality improvement.

S:US is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. S:US is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities, including allowance of the use of services animals. To request reasonable accommodation or if you believe such a request was improperly handled or denied, contact the Director of Recruitment.

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