Compliance Specialist
 Merakey | |
 United States, Pennsylvania, Lafayette Hill | |
 Feb 11, 2025 | |
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Are you looking for an opportunity to advance your career while working with an extraordinary team? At Merakey, we put heart and soul into everything we do. We are seeking a Compliance Specialist to join our team.
Location: Remote (Open to Candidates Residing in PA, DE, FL, LA, MD, NJ, OH, TX, VA) Earn between $48,000-$52,000 Merakey is currently seeking a Compliance Specialist to join our corporate Quality & Compliance Organization team. Position Summary: The Compliance Specialist shall be responsible for conducting focused investigations within a large behavioral health, intellectual disability, and educational provider to determine compliance in accordance with laws, regulations, program service description, policies and payer requirements. Location: Employee must be able to physically report into one of the following Merakey locations on a hybrid basis: Philadelphia Harrisburg General Responsibilities: * Responsible to manage assigned cases, including the following case types; Compliance Investigations (i.e.: Investigation Standard), Initial Inquires, Complaints, Compliance Audit, Payer Audit, Payer Directed Self Audit, Quality Review and Questions/Consultations. Case management functions require responsibility to manage the investigatory time frames and tasks required for each assigned case. * Maintains a supportive role through participation in collaborative projects within Merakey Quality and Compliance Organization, to include Privacy, Quality, Safety and Incident Management. * Participation in corporate and/or divisional workgroups; representing QCO and Compliance perspective. * Utilization of the company's EHR systems, for each respective Division, for responsibilities associated with assigned cases. This includes billing reports, documentation reports and chart documentation associated with an assigned case/investigation. * Coordinate notification of investigation outcomes through scheduled Findings Calls; inclusive of Operations, Human Resources and other identified Merakey Department services representatives. Competencies and Skills: * Verbal Communication-demonstrates appropriate and professional interpersonal skills related to the investigatory process, to include facilitation of interviews, in-person program review(s) and meetings. Time Management-exhibits the ability to assess and manage priorities, as needed/required to meet the requested supports of divisions and corporate departments. * Written Communication-demonstrates competency with written investigatory findings/report structure, as well as maintaining case records within the QCO data base system. * Maintains objectivity throughout the investigatory process, with assigned cases and investigations. This is demonstrated through verbal and written communication aspects of the position/job responsibilities. This includes face to face/phone/video conference interview(s), investigatory summaries, verbal findings review. * Performs other duties as assigned by supervisor. Our ideal candidate will possess the following skills: * Bachelor's Degree in Human Services, Business Administration or related field preferred but not required or equivalent experience. * Available for travel around 30% of the time. * Experience conducting Compliance and Certified Incident Investigations in a human services/healthcare organization is preferred. * Certified Investigator Certification is preferred. * Must be fully vaccinated or have an approved exemption. Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled | |