ZipRecruiter
Compliance Delegation Coordinator
ZipRecruiter, Los Angeles, California, United States, 90079
Job DescriptionJob Description
MedPOINT Management is committed to conducting its business and operations following the highest legal and ethical standards. Our Code of Conduct sets forth our expectations of management, employees, and contractors to act under applicable laws and Company policy. MedPOINT’s Compliance Department ensures our culture maintains ethical standards, strives to significantly reduce the risk of fraud, abuse, and waste in the healthcare industry, and enhances the quality of services and care to patients. The Federal Sentencing Guidelines for Compliance Programs guide MedPOINT’s Compliance Program.
Duties and Responsibilities
1.
Prepares and submits audit universe reports to external auditors from health plans
2.
Review and validate audit documents to external auditors from health plans
3.
Assists with internal quality reviews of department processes
4.
Supports Health Plan Oversight Audits/Ad Hoc Requests
5.
Supports internal quality review of the PNO process
6.
Participate in Regular and Ad Hoc Compliance meetings
7.
Back up personnel for communicating reminders to business owners for upcoming external audits for universe selections, pre-audit materials, and approaching corrective action deadlines
8.
Interface with various departments for compliance-related activities as needed
9.
Miscellaneous projects as assigned to support Regulatory Affairs & Compliance department
10.
Adhere to MedPOINT Management’s core values: Accountability, Community, Celebration, Integrity, Innovation & Collaboration
Minimum Job Requirements
·
High School diploma or equivalent.
·
Experience in an HMO or in a Managed Care setting .
Skill and Abilities
·
Advanced knowledge of Microsoft Applications, specifically Excel.
·
Knowledge of EZ-CAP® is a plus.
·
Knowledge of Customer Service, Claims, or Referral processing in a health care setting
·
Managed Care, and State and Federal regulations a plus.
·
Professional demeanor, excellent communication, and interpersonal skills.
· Strong organization skills and knowledge of managed care environment.
MedPOINT Management is committed to conducting its business and operations following the highest legal and ethical standards. Our Code of Conduct sets forth our expectations of management, employees, and contractors to act under applicable laws and Company policy. MedPOINT’s Compliance Department ensures our culture maintains ethical standards, strives to significantly reduce the risk of fraud, abuse, and waste in the healthcare industry, and enhances the quality of services and care to patients. The Federal Sentencing Guidelines for Compliance Programs guide MedPOINT’s Compliance Program.
Duties and Responsibilities
1.
Prepares and submits audit universe reports to external auditors from health plans
2.
Review and validate audit documents to external auditors from health plans
3.
Assists with internal quality reviews of department processes
4.
Supports Health Plan Oversight Audits/Ad Hoc Requests
5.
Supports internal quality review of the PNO process
6.
Participate in Regular and Ad Hoc Compliance meetings
7.
Back up personnel for communicating reminders to business owners for upcoming external audits for universe selections, pre-audit materials, and approaching corrective action deadlines
8.
Interface with various departments for compliance-related activities as needed
9.
Miscellaneous projects as assigned to support Regulatory Affairs & Compliance department
10.
Adhere to MedPOINT Management’s core values: Accountability, Community, Celebration, Integrity, Innovation & Collaboration
Minimum Job Requirements
·
High School diploma or equivalent.
·
Experience in an HMO or in a Managed Care setting .
Skill and Abilities
·
Advanced knowledge of Microsoft Applications, specifically Excel.
·
Knowledge of EZ-CAP® is a plus.
·
Knowledge of Customer Service, Claims, or Referral processing in a health care setting
·
Managed Care, and State and Federal regulations a plus.
·
Professional demeanor, excellent communication, and interpersonal skills.
· Strong organization skills and knowledge of managed care environment.