Coding Compliance Specialist jobs in Utica, NY

Description

Job Summary:
The Compliance Specialist applies ethical and confidential auditing and investigatory standards to effectively review and evaluate/assess that CCANY’s practices and documentation comply with all related laws, regulations and CCANY policies, procedures, and guidelines. Audits are completed in accordance with schedules and deadlines; and findings (both verbally and written) are communicated objectively.

Supervisory Responsibilities:
• None.

Essential Duties and Responsibilities:
• Follows CCANY’s program of audit coverage for the organization; may participate in the development of CCANY’s Audit and Investigation programs, policies, and procedures.
• Assists in the planning of the scope of the audit and audit procedures to be used.
• Evaluates the effectiveness and adequacy of internal controls.
• Identifies potential risk exposures and factors contributing to issues related to internal controls, non-compliance, or errors.
• Prepares and submits audit reports, memorandums and other data summarizing the results of financial and/or operational reviews.
• Reviews audit results with Assistant Director of Compliance
• Assists in developing corrective action plans.
• Evaluates the adequacy of the corrective action taken to improve unsatisfactory conditions and follows up with program management until all items are resolved adequately.
• Conducts special reviews at the request of management.
• Coordinate and conduct investigations of suspected or actual internal fraud at the request of management.
• Performs other duties as assigned including involvement with departmental and organizational project teams, committees and task forces, training initiatives and other program support functions.
• Maintain a working knowledge of all developments in regulatory requirements, general accounting, and audit techniques.
• Meets all safety training requirements, adheres to all safety policies, reports all unsafe conditions, takes measures to prevent accidents and/or eliminate conditions that pose a safety or health risk.
• Performs other duties, as assigned.
• Must possess a valid Driver’s License from New York, or a contiguous state (i.e., Connecticut, New Jersey, Pennsylvania, and Vermont) OR Must have the ability to take ample public transportation to attend meetings in person in the community and in the office as needed.

Qualifications

• Bachelor’s degree, preferably in Human Services, Health Care Management, or related field, and three (3) years experience in OPWDD, DOH, Incident Management, Compliance, and/or policies and investigations.
o -Or- Master’s degree one (1) year as above
o -Or- Associate’s Degree four (4) years as above
o -Or- HS Diploma/GED five (5) years as above
• Excellent working knowledge of Microsoft Word and Excel.
• Fluency or the ability to rapidly become fluent in applicable laws, regulations, policies, and procedures, to ensure proper review and facilitate best practices.
• Travel as directed per business necessity to CCANY’s locations or elsewhere as directed, to execute duties.
• Maintain comprehensive understanding at all times of the potential ramifications of potential errors, whether in the items being reviewed or the review itself, regarding the potential for harm, both individually and organizational.
• Strong organizational and project management skills and demonstrated attention to detail.
• Ability to use discretion and maintain the confidentiality of information obtained in conduct of work.
• Excellent interpersonal, public speaking, and written communication skills.
• Strong documentation, analytical, and problem-solving skills are required.
• Experience working with Electronic Health Records.
• Ability to work autonomously.