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Audit Specialist- Risk Assessment & Compliance in Fern Park, FL at Aspire Health Partners

Date Posted: 9/25/2018

Job Snapshot

Job Description

Job Purpose: As Audit Specialist at Aspire Health Partners, your job purpose will be to provide a multitude of essential functions to provide required support of the department. These functions include – but are not limited to –

  1. Primary emphasis of creating, planning, designing and performing audits and reviews of service related and other contractual/funding source compliance requirements. Ensuring the company is experiencing the highest possible level of quality EHR and manual entry and reporting. Recommending corrective action, and following up on the results of the corrective action.
  2. Participating in or leading discussion and/or training workshops to positively effect change in clinical documentation results.
  3. Assisting the Lead Compliance Specialist with Aspire Compliance Program’s maintenance and development, specifically focusing on expanding audit processes company-wide.
  4. Assisting the Risk Assessment & Compliance Director and the Senior Vice President of Operations with matrix management reporting and monitoring activities, including creation and dissemination of reports ranging from summary dashboard indicators to specific, detailed information.
  5. Actively participating in the Risk Assessment and Compliance Team, and reviewing and educating staff on all company specific Medicaid and Medicare regulations. Assisting in the coordination of notifying other departments of any changes to forms, processes billing documentation, and any information related to new or revised service code. In addition, ensuring that all staff is trained on any new specific Medicaid and Medicare rules and/or regulations.
  6. Engaging in and reporting to Supervisor on any assigned activities.
  7. Preparing ad-hoc and regular reports as needed.
  8. Assisting in contract management, information systems, quality assurance, and accreditation functions as assigned.
  9. Cooperating fully with teaching and learning various component function to maximize cross-training efforts at the direction of the component supervisor/coordinator/director;
  10. Performing other duties as assigned by Supervisor.

 

In addition, the Compliance Specialist must maintain positive working relationships, assist in resolving discrepancies, and complete required trainings and/or attend and participate in meetings when necessary. Most importantly, all functions must be completed while maintaining high standards of ethical and professional conduct while adhering to agency policies and procedures.

Job Requirements

Position qualifications: Ability to receive and maintain a(n)

  • Level II Background clearance
  • Acceptable Motor Vehicle Registration driver’s license record in accordance with the underwriting guidelines set by Aspire’s insurance company.

 

Bachelor’s degree in Business Administration, Healthcare Administration, or Health Services related field is preferred or at least one years’ experience working in a research facility, quality assurance department, hospital/clinic, investigative department, managed care office or behavioral healthcare organization.

Other qualifications:   EHR experience along with auditing/monitoring/review experience is required. The successful candidate will: (1) be computer literate, (2) have the ability to quickly learn agency processes, (3) possess intermediate-advanced Excel and Word skills, and will have working knowledge of database operations, (4) be able to positively handle stress indigenous to performing in a perpetual oversight role, and (6) be a team player.