Senior Compliance Specialist
Job Summary
Supporting the compliance department remotely, the full-time Senior Compliance Specialist will manage internal and external audits, investigate Fraud, Waste & Abuse claims, and ensure adherence to regulatory requirements.
Key responsibilities
- Conduct and respond to internal and external audits across all jurisdictions
- Investigate Fraud, Waste & Abuse claims and suggest next steps for resolution
- Assist with conflict reporting and collaborate with the finance department to resolve issues
Required qualifications
- Bachelor's degree with a minimum of 3 years of experience in the healthcare industry, or an Associate degree with a minimum of 5 years of experience
- Extensive knowledge of Medicaid regulations
- Experience with exclusion screening and background checks
- Preferred knowledge of billing and coding
- Prior experience with internal and external audits
Complete Job Description
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