Compliance Specialist
: Job Details :

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 at our program. This is a remote position. Location: Employee must be able to physically report to one of the following Merakey locations on a hybrid basis: Philadelphia Harrisburg Greensburg Pittsburgh 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. Responsible to manage assigned cases, including the following case types: Compliance Investigations (i.e.: Investigation Standard), Initial Inquiries, 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 responsibilities associated with assigned cases, including billing reports, documentation reports, and chart documentation. 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, including facilitation of interviews, in-person program reviews, and meetings. Time Management - exhibits the ability to assess and manage priorities 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 database system. Maintains objectivity throughout the investigatory process, demonstrated through verbal and written communication aspects of the position. Performs other duties as assigned by supervisor. Compensation: Earn $48,000-$51,000 annually. Application: To fill out an online application: /careers Requisition number: 93025 Benefits: DailyPay Work/Life Balance Flexible Schedules Cell Phone Discount Plans Employee Referral Bonuses Tuition Reimbursement Membership About Merakey: Merakey is a non-profit provider of developmental, behavioral health, and education services. More than 8,000 employees provide support to nearly 40,000 individuals and families throughout 12 states across the country each year. Merakey strictly follows a zero-tolerance policy for abuse. Merakey is proud to be an Equal Opportunity Employer! We deeply value diversity and do not discriminate on the basis of race, religion, color, national origin, ethnic background, sex, gender, gender identity, sexual orientation, age, marital status, veteran status, genetic information, or disability status. We encourage applicants from underrepresented backgrounds to apply, and we welcome all Veterans to apply! Ideal Candidate: 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#J-18808-Ljbffr